Health SA Gesondheid

Critical assessment of health financing indicators and expenditure in South Africa

Njabulo I. Mkhize — 2026-02-18

Background: Despite the increased funding and advancements in providing public health services, the health system continues to be challenged by the high prevalence of diseases.

Aim: The objective of this study is to review health sector financing in South Africa by highlighting causes for spending pressures in the health system. The study setting comprised the National Department of Health in Pretoria.

Method: The study employs a qualitative approach by reviewing the literature on healthcare financing and expenditure in South Africa through the analysis of multiple electronic database searches to provide insight into trends and behaviour of health care budgets, expenditure, and health financing indicators.

Results: Health financing indicators reveal that South Africa’s real health budgets have increased over the past years. However, the increase has barely kept pace with population growth rates. Also, the analysis of the consumer price index (CPI) and medical inflation shows that the costs for medicines and other consumables have, over time, remained significantly above the normal consumer inflation.

Conclusion: The rising trend in population growth and life expectancy rates suggests that health care funding will need to rise considerably in the next decade as individuals live longer and are anticipated to be given unrestricted access to public health services.

Contribution: This study deepens the comprehension that, while reforms in the health sector and mobilisation of additional resources are essential for tackling disparities and access to health care, it is also crucial to examine and improve the efficiencies in the utilisation of these resources.

Nurses’ perceptions of family-centred care in neonatal intensive care units: Rapid qualitative evidence synthesis of studies in low- and middle-income countries

Clara Wepener — 2026-03-11

Background: Family involvement in the neonatal intensive care unit (NICU) benefits both the infant and the family; however, nurses working in the NICU in low- and middleincome countries (LMICs) face unique contextual challenges that influence the practice of family-centred care (FCC).
Aim: This rapid review aims to synthesise nurses’ perceptions of FCC in NICUs in LMICs and to identify factors influencing its implementation in these contexts.
Method: Electronic databases were searched for relevant studies published between 2020 and 2025. A Preferred reporting items for systematic reviews and meta-analyses (PRISMA) diagram depicts the study selection process. The Joanna Briggs Institute’s (JBI) Critical Appraisal Checklist for Qualitative Research was used for quality assessment of the selected articles, and data were charted using the JBI extraction instrument. Descriptive thematic synthesis was used to synthesise and report the findings.
Results: The search generated 1598 articles, with 9 studies from 5 different LMICs meeting the selection criteria. The synthesis of the findings resulted in the identification of 6 themes, namely policies and resources, cultural and contextual variables, nurses’ roles and responsibilities, nurse-family dynamics, staff dynamics and support and training.
Conclusion: Nurses in LMICs expressed varied views on involving families in NICUs and highlighted the influence of cultural and contextual factors. They emphasised the need for clear guidelines, adequate resources and appropriate support and training to enable successful implementation.
Contribution: The review provides a single point of access of contextualised synthesised
findings of factors influencing the implementation of FCC in LMIC NICUs.

Emotional challenges faced by student nurses during clinical placement: A scoping review

Levon Lubbe — 2026-04-24

Background: Clinical practice is a highly valued learning opportunity to develop the appropriate techniques as student nurses. However, students are experiencing traumatic events during clinical placements without adequate emotional support. This causes emotional challenges that are difficult to manage.
Aim: To explore emotional challenges experienced by student nurses during clinical placements when exposed to traumatic events.
Method: This scoping review followed Arksey and O’Malley’s framework, using the Joanna Briggs Institute (JBI) Manual for Evidence Synthesis to extract and chart sources. Nineteen articles (2014–2024) were analysed using descriptive analysis, Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) and thematic analysis.
Results: Three themes, namely, psychological resilience, emotional strains and impact on nursing education environment, and coping strategies, emerged from this scoping review. These themes and sub-themes are used to make recommendations.
Conclusion: This scoping review highlights that nursing students face significant emotional challenges, including burnout, insecurity and traumatic experiences, which affect their resilience and well-being. The findings emphasise systemic issues within clinical and academic environments, such as workload pressures, limited support and gaps in preparedness, that exacerbate emotional strain. Positive coping strategies, resilience-building interventions and supportive mentorship were linked to professional growth.
Contribution: The findings from this scoping review might assist in addressing these challenges through curriculum reform, intentional resilience and coping skills training and structured emotional support systems.

Enhancing holistic nursing care for sexual and gender minorities: A scoping review of global training initiatives

Sibonelo Ndlovu — 2026-04-28

Background: Holistic nursing care integrates the physical, social, spiritual and psychological dimensions of well-being. Sexual and gender minority (SGM) groups experience healthcare disparities because of non-inclusive policies. To provide culturally competent care, nurses must receive training in addressing the needs of SGM individuals.
Aim: This review synthesises evidence on the training nurses receive to deliver holistic care to SGM groups.
Methods: Four electronic health databases – MEDLINE, Web of Science, ProQuest (Nursing & Allied) and EBSCOhost (CINAHL) – were searched for articles on nurses’ training for holistic care of SGM people, published between 2021 and 2025. Screening and reporting adhered to PRISMA flowchart guidelines, and Population, Concept and Context framework was utilised.
Results: Three key themes emerged: the beneficial outcomes of healthcare training for nurses on SGM issues, factors hindering nurses from providing holistic care to SGM groups and characteristics of content in nursing education.
Conclusion: Programmes aimed at equipping nurses to deliver holistic nursing care to SGM individuals require improvements in both their duration and delivery methods. It is imperative for higher education institutions to prioritise the provision of training on SGM issues for nurse educators, as this initiative is essential for substantially improving curriculum development. Collaboration among stakeholders can enhance healthcare outcomes for SGM groups.
Contribution: This review can inform policies affecting SGM individuals, while helping develop a culturally competent workforce.

Service delivery strategies for perinatal mental health in Sub-Saharan Africa: A scoping review

Manoko I. Lediga — 2026-06-10

Background: Mental health conditions, such as depression and anxiety, affect many women during the perinatal period. These conditions are particularly prevalent in lowand middleincome countries and low-resource settings, where access to quality mental health services is limited. This highlights the urgent need for effective strategies to identify, support and empower women experiencing perinatal mental health difficulties.

Aim: This scoping review synthesised existing evidence on strategies to improve access to perinatal mental health services in sub-Saharan Africa (SSA).

Method: A scoping review was conducted using databases including EBSCOhost, Scopus, PubMed and Web of Science. Studies published between 2015 and 2025 in English were included. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews checklist.

Results: The initial search identified 735 records, of which only four met the inclusion criteria. These studies employed varied approaches, enriching the synthesis by capturing diverse perspectives and methodological insights. This variation strengthened the comprehensiveness and credibility of the findings.

Conclusion: Sustainable improvements in perinatal mental health services in SSA require investment in workforce development, culturally adapted interventions and supportive policies. Contribution: This review contributes to the growing body of knowledge on perinatal mental health in SSA and offers guidance for future strategies aimed at prioritising mental health services for perinatal women.

Nurse and caregiver skill mix, staffing levels, and staff allocation in long-term care facilities: A scoping review

Emerentia C. Nicholson — 2026-08-06

Background: More older people require healthcare services, increasing the demand for nursing
care. Long-term care facilities (LTCFs) are required to avail nurse staffing, a skill mix and
allocation that is aligned with residents’ acuity and within prescribed legislation. However,
facilities struggle to maintain the prescribed nurse staffing.
Aim: A scoping review was conducted to map the available literature on implementing nurse
and caregiver staffing models within LTCFs regarding skill mix, staffing levels, and staff
allocation aligned with residents’ acuity.
Setting: Studies conducted in formal long-term care settings for older people.
Methods: The review followed the Joanna Briggs Institute’s methodological framework. The
search included four databases: PubMed and MEDLINE, CINAHL, Cochrane Library–
Wiley, and Sabinet African Journals, for studies published from 2010 to 2024. Trustworthiness
was ensured by applying principles such as credibility, dependability, confirmability, and
researcher reflexivity. The final sample comprised 20 studies.
Results: Staffing levels for all categories of nurses and caregivers were often lower than
recommended by experts. The number of registered nurses versus caregivers in the total staff
mix was low, with caregivers providing most of the resident care. The use of acuity-adjusted
staffing was not often reported.
Conclusion: The appropriate type and number of staff in LTCFs are essential. In addition,
allocating the correct type and number of staff according to residents’ acuity levels may
improve resident outcomes.
Contribution: This review may inform policymakers regarding the implementation of staffing
models and the importance of aligning the allocation of tasks with the nurses’ scope of practice,
the caregivers’ job descriptions, and the residents’ acuity.

Exploring the impact of HIV and AIDS among marginalised farming communities in the Eastern Cape province, South Africa

Ragosebo P. Sekopa — 2026-08-20

Background: The HIV and AIDS epidemic on a global level continues to be a challenge in contemporary societies. The impact of HIV and AIDS on the workforce in the agricultural sector in Africa needs to be explored.

Aim: The study aimed at exploring and describing the impact of HIV and AIDS on the farming labour force among marginalised farming communities at Oliver Reginald (OR) Tambo District in Eastern Cape province, South Africa.

Method: The study utilised a qualitative research approach with exploratory and descriptive designs, employing in-depth interviews for data collection. Thematic analysis was conducted based on the framework established by Braun and Clarke.

Results: The study found that HIV and AIDS have significantly negative impacts on labour, farming skills, income and food security in marginalised farming communities in the OR Tambo Municipality. Additionally, there are challenges in accessing healthcare services, leading to treatment defaults.

Conclusion: HIV and AIDS directly affect the labour force, impacting households’ capacity to produce food or attend work to earn wages for food purchases. Contribution: The findings from the study would assist local stakeholders, farming forums and the Department of Rural Development and Agriculture in managing HIV and AIDS with respect to the farming labour force and farming during their programme revisions and implementation planning.

Contribution: The findings from the study would assist local stakeholders, farming forums and the Department of Rural Development and Agriculture in managing HIV and AIDS with respect to the farming labour force and farming during their programme revisions and implementation planning.

Perceptions of artificial intelligence among radiology department professionals in African hospitals: A scoping review

Tshifhiwa Nekhudzhiga — 2026-08-20

Background: The Fourth Industrial Revolution (4IR) is driving the integration of artificial intelligence (AI) into healthcare, with radiology emerging as a key area of transformation. Artificial intelligence offers the potential to enhance diagnostic accuracy, workflow efficiency, and clinical decision-making. However, implementation in Africa is challenged by limited infrastructure, digital capacity, and training. Understanding radiology professionals’ perceptions is vital for guiding effective and ethical adoption.

Aim: This scoping review aimed to identify and map existing literature on the perceptions of radiology professionals regarding the use and adoption of AI in African healthcare settings.

Method: Following the Joanna Briggs Institute (JBI) methodology, a systematic search across Web of Science, ScienceDirect, and Scopus identified eight studies (2021–2025) involving 2467 radiology professionals. Data were thematically analysed to map perceptions, opportunities, and barriers to AI adoption.

Results: Radiology professionals generally viewed AI positively, recognising its benefits for diagnosis and efficiency. However, concerns included limited AI knowledge and training, infrastructural and technological constraints, high implementation costs, and weak governance frameworks. Most professionals saw AI as a supportive rather than a replacement tool.

Conclusion: Radiology professionals across Africa are receptive to AI but face educational, infrastructural, and regulatory challenges. Targeted training, stronger digital infrastructure, and robust governance are needed for sustainable adoption.

Contribution: This review consolidates current evidence on African radiology professionals’ perceptions of AI, highlighting critical gaps in knowledge, readiness, and governance that can inform future policy and research.

A review of lead times and determinant factors in public optometry services in South Africa

Mapula P. Rapao — 2026-09-07

Background: Lead time is the total time spent by a patient in a facility from their arrival until the end of the last service they receive. Increased waiting times, which are idle times, in between service points within a service system significantly lengthen the lead times.
Aim: To review lead times and the determinant factors in public optometry services in South Africa.
Methods: Literature was reviewed from Google Scholar, PubMed and ScienceDirect databases using key terms such as ‘lead time’, ‘waiting times’, ‘optometry services’ and ‘public hospitals’. To obtain more data about optometry services and wait times in public hospitals, seven websites were also included.
Results: It was determined that 38 academic papers were pertinent to the review. Fifteen were optometry and eye care, six on lead time,six on triage, three queuing theory, one on patient flow, three on lean theory and two on frame work. Human resource limitations, insufficient equipment, unequal optometrist distribution and ineffective referral and patient flow mechanisms are among the main issues influencing lead times.
Conclusion: To address the prolonged lead times for service in optometry, the report emphasises the urgent need for systemic changes in rural South African public hospitals. To ensure patients receive prompt and efficient eye care. It is imperative to increase the availability
of qualified staff, upgrade infrastructure and expedite procurement procedures.

Contribution: This study not only sheds light on existing debates on lead times and the system-level factors such as human resources, infrastructure and patient flow inefficiencies that influence them in South African public optometry services, but it also highlights important knowledge gaps and offers guidance for further studies and improvements in the healthcare system.

Digital therapeutics for stress in health science students at under-resourced universities: A narrative review

Bhekithemba Vellem — 2026-09-07

Background: Health science students’ well-being and academic performance are important concerns in under-resourced universities. However, there is limited insight into mHealth interventions and institutional support for psychological stress driven by demanding curricula and socioeconomic disparities. Digital therapeutics (DTx) offer scalable technology-enabled support for stress management.

Aim: This narrative review explores how DTx can complement or enhance existing stress management approaches for health science students in under-resourced South African universities.

Methods: A narrative literature search was conducted across four databases: PubMed, Scopus, Web of Science and Google Scholar. Publications were from 2020 to 2024 on DTx addressing stress among university students, in low-resource settings and theoretical foundations. PRISMA guidelines informed reporting, and thematic synthesis followed Braun and Clarke. Theoretical frameworks informed analysis of effectiveness, the digital divide and mental health service integration.

Results: The synthesis of nine studies, institutional reports and grey literature yielded four main themes: infrastructural and financial constraints, psychological and sociocultural barriers, facilitators and success factors and integration with university mental health services.

Conclusion: Barriers included poor connectivity, high data costs, limited digital literacy, stigma around mental health and weak institutional support. Effective DTx adoption in lowresource settings requires overcoming barrier and strengthening policy, practice and research.

Contribution: Digital therapeutics have the potential to play an important role in addressing mental health inequities among health science students in South Africa and similar contexts. The study contributes insights into digital health interventions to enhance support systems in higher education.

Prevalence of physical activity involvement among older adults in Africa: A scoping review

Ernest A. Bekoe — 2026-10-07

Background: The global rise in the population of older adults has significant health implications, particularly in Africa, where demographic transitions are accelerating. Reduced participation in physical activity (PA) is a key determinant of chronic disease burden, functional decline and poor quality of life. Despite its importance, evidence on PA participation among older adults in Africa remains fragmented.
Aim: To synthesise evidence on the prevalence of PA involvement among older adults in Africa.
Methods: Peer-reviewed studies were systematically searched across PubMed, SCOPUS, Web of Science, CINAHL and Google Scholar. Search terms combined prevalence, older adults, physical activity and participation. Eligible studies included studies of older adult populations that reported PA prevalence. Three reviewers independently screened and appraised the studies. Data were charted and synthesised narratively.
Results: Seven studies revealed significant variability in physical activity levels among older adults in Africa, with low engagement in South Africa and Ethiopia, while Ghana showed higher levels of vigorous activity. The main barriers included advanced age, low income, obesity and a lack of awareness, whereas encouragement from family and healthcare professionals helped enhance participation.
Conclusion: In general, physical activity levels among older adults remain low and are influenced by contextual factors, underlining the importance of addressing social and economic challenges.
Contribution: This review contributes by consolidating evidence on physical activity among older adults in Africa, exposing research gaps and practical needs. Based on these insights, healthcare providers should encourage activity, give clear advice and work with communities to strengthen support systems.

Peer navigation to support psychosocial well-being and HIV treatment among adolescents: A rapid review

Charné Petinger — 2026-10-07

Background: Adolescents living with HIV (ALHIV) in sub-Saharan Africa experience poorer outcomes across the HIV care cascade than other age groups because of intersecting developmental, psychosocial and structural barriers. Peer navigation has emerged as a promising strategy to support engagement in care, yet evidence on its effectiveness and
implementation for ALHIV remains fragmented.
Aim: To synthesise evidence on peer navigation and peer-led psychosocial support interventions for adolescents living with HIV.
Method: A rapid review was conducted in accordance with PRISMA 2020 principles. PubMed and EBSCOhost databases were searched for qualitative, quantitative and mixedmethods studies published between 2013 and 2025.
Results: Fourteen studies conducted across eight countries were included. Peer navigation interventions were typically delivered by young adults living with HIV who were stable on treatment and trained to provide psychosocial, adherence and health system navigation support. Most studies reported improvements in antiretroviral therapy adherence, retention in care and viral suppression, although effects varied by context and were not always sustained. Psychosocial benefits included reduced stigma, strengthened trust and improved self-efficacy. Implementation findings indicated high acceptability and feasibility, supported by structured training and supervision, alongside challenges related to sustainability and structural barriers such as transportation costs.
Conclusion: Peer navigation is a valuable component of adolescent-friendly HIV care in sub-Saharan Africa, particularly when integrated within responsive clinical systems and complemented by strategies addressing structural vulnerability.
Contribution: This review consolidates regional evidence on peer navigation for ALHIV and provides implementation-relevant insights to inform the integration and scale-up of peer-led models within public sector HIV services.

Scaling up implementation of the E-MOTIVE bundle for early detection and management of postpartum haemorrhage emergencies: A scoping review

Maurine R. Musie — 2026-10-07

Background: Postpartum haemorrhage (PPH) remains a leading cause of maternal mortality
globally. Effective management of PPH demands the implementation of E-MOTIVE bundle for
early detection and management of PPH as recommended by the World Health Organization
(WHO).
Aim: The scoping review aimed to map evidence on the implementation of the E-MOTIVE
bundle for early detection and management of PPH emergencies globally.
Methods: The review adopted the Arksey and O’Malley methodological framework (2005).
Six databases (CINAHL, MEDLINE, Scopus, PubMed, Web of Science and ProQuest) were
searched for sources. The inclusion criteria consisted of full-text articles in English published
between 2015 and 2025.
Results: A total of 14 articles were selected. The review revealed: 1. Types of PPH bundles,
2. Implementation strategies of E-MOTIVE bundle. 3. Barriers to effective implementation
of the E-MOTIVE bundle.
Conclusion: A bundled care approach for the management of PPH following vaginal delivery
has been shown to reduce adverse maternal outcomes because of PPH.
Contribution: The review addresses a critical gap in the implementation and suggests
implementation strategies of the E-MOTIVE bundle, including objective blood loss estimation,
scalable training, adoption to national policies and teamwork among the obstetric team.

Mapping evidence on support networks and their impact on postnatal teenage mothers’ mental health in a global context: A scoping review

Rinae Sikhwari — 2026-11-06

Background: Postnatal teenage mothers faced unique mental health challenges because of the combined effects of adolescence and early motherhood. While the importance of support networks was acknowledged, a comprehensive understanding of their influence across global and African contexts remains limited.
Aim: This scoping review aimed to map existing research on support networks available to postnatal teenage mothers and explored their impact on mental health outcomes. The review included studies from healthcare and community settings across South Africa, Kenya, Ghana, United Kingdom, Indonesia, Turkey, Canada, Mozambique, Brazil, Iran, Jordan and Nairobi.
Method: A systematic search identified 15 articles published between 2020 and 2025 from Web of Science, EBSCOhost, ProQuest, Google Scholar, and PubMed. Studies using qualitative, quantitative, and mixed-methods approaches were included after Preferred Reporting Items for Systematic Reviews and Meta-Analyses-guided screening of 1242 records, with data thematically synthesised.
Results: Ten main themes emerged from thematic analysis of the included studies, namely lack of family support, lack of healthcare professional support, digital support, financial support, emotional support, physical support, absence and accessibility of partner or spousal support, lack of social support, mental conditions and support in developed settings. Family’s emotional or practical support protected against postpartum depression and anxiety, while partner involvement and financial stability significantly influenced outcomes. Digital support showed promise where formal services lacked accessibility.
Conclusion: Integrated, adolescent-sensitive support networks proved critical for promoting mental health among postnatal teenage mothers. Addressing service gaps, social stigma and strengthening family or partner support remained essential for improving well-being in this vulnerable group.
Contribution: This review mapped support network types and their mental health impacts, providing evidence for targeted policy development and clinical interventions tailored to teenage mothers’ unique needs across diverse global contexts.

Understanding adolescent substance abuse in a Northern Cape township: Educators’ experiences and perceptions

Keikeditse E. Mohomane — 2026-02-18

Background: Learner substance abuse is a global public health concern contributing to preventable injuries, poor academic performance, and increased dropout rates. Addressing it in schools is crucial for improving both educational and health outcomes.

Aim: This study explores high school educators’ perceptions and experiences of learner substance abuse.

Setting: The study was conducted in six high schools in Galeshewe Township, Northern Cape province.

Methods: A qualitative, exploratory and descriptive approach was employed. Sixteen Life Orientation (LO) educators were purposively sampled for in-depth interviews. Data were collected using a semi-structured guide until saturation. Trustworthiness was ensured through credibility, dependability, transferability, and confirmability. Thematic analysis followed Braun and Clarke’s six-step process, with transcription via Microsoft Word and Excel.

Results: Four themes emerged: factors driving learner substance abuse, educational disruptions, educator training and support, and intervention strategies. Educators reported substance abuse as common both in school and off-premises especially among older boys. They also observed an increasing trend among younger learners and girls. It was linked to disruptive behaviour affecting teaching and learning. Educators felt unprepared to manage these issues and criticised the LO curriculum’s limitations.

Conclusion: Educators emphasised the need for specialised training programmes to equip them with skills to manage learners involved in substance abuse. They also called for greater support from leadership in the Department of Education.

Contribution: The study’s findings highlight the challenges of learner substance abuse in the Northern Cape and provide context-specific interventions that can be used to inform policy that addresses substance abuse in schools.

Climate change and eye health: Awareness of health sciences students at a South African University

Hlabje C. Masemola — 2026-02-18

Background: Climate change is an increasingly global issue with significant adverse impacts on public health. Its effects can lead to an increase in ocular health problems and diseases.

Aim: To determine the knowledge and perception among final-year students registered in the School of Health and Rehabilitation Sciences at the University of the Free State Bloemfontein, on the impact of climate change on eye health.

Setting: The study was conducted at the University of the Free State, Bloemfontein campus.

Methods: A descriptive study was carried out using a self-administered questionnaire. Responses were collected during June 2024 and July 2024, and the results were analysed using descriptive statistics using SAS version 15.2.

Results: A total of 107 final-year health science students participated in the study, with a response rate of 85.60%. The study found a high level of awareness about climate change, with 99.07% (n = 106) acknowledging its occurrence. However, 64.49% (n = 69) of the participants felt they were not well informed about climate change issues, while 35.51% (n = 38) felt adequately informed. In addition, 93.46% of participants believed that protecting their eyes outdoors can reduce the risk of climate change-related eye health issues.

Conclusion: The study highlights the varying levels of knowledge among future healthcare professionals, emphasising the need for enhanced educational initiatives to bridge gaps in understanding.

Contribution: This study adds to the broader public health conversation by highlighting the connection between specific environmental changes and eye health. It calls for detailed approaches to reduce the negative impacts of climate change on eye health.

Radiographers’ self-perceived knowledge regarding infection control in the Free State province during the COVID-19 pandemic

Ida-Keshia Sebelego — 2026-02-18

Background: Radiographers are regarded as essential healthcare workers. Therefore, knowledge and training regarding infection control are vital to minimise the potential risk of infections to patients.

Aim: The aim of the study was to investigate the self-perceived knowledge of infection control among qualified radiographers and diagnostic radiography students.

Setting: The study was conducted in three public sector radiology departments during the coronavirus disease 2019 (COVID-19) pandemic.

Methods: A quantitative questionnaire was completed by 106 participants comprising radiographers and students of diagnostic radiography. Data were analysed using SAS version 9.4. The Wilcoxon two-sample and Kruskal-Wallis tests were performed to calculate the difference between the median values and to determine the significant differences between the experience, training cycle of infection knowledge, and knowledge of the participants.

Results: Only 30.2% (n = 32) of the participants knew that hands are the most basic mode of transmitting infections, while 98.1% (n = 104) knew that long fingernails harbour microbes. The participants’ knowledge of infection control was low to adequate. They rated themselves as having adequate to excellent knowledge about infection control. However, their median score was 60% which demonstrates an adequate level of knowledge. No significant relationship was noted between training and knowledge nor between the years of experience and knowledge.

Conclusion: Considering the findings, radiographers’ and student radiographers’ knowledge of infection control requires improvement. An infection control audit accompanied by in-service training on infection control might encourage radiographers to comply with infection control guidelines and enhance their knowledge.

Contribution: While infection control has been widely studied, fewer studies focus specifically on diagnostic radiography students and radiographers, despite their direct patient contact and exposure to infection risks. The study provides much-needed data for this under-researched group.

Midwives’ cardiotocograph interpretation and documentation knowledge in a selected Gauteng hospital

Sifiso Dlamini — 2026-02-18

Background: Cardiotocography (CTG) is a globally used intrapartum monitoring tool to assess the foetal heart rate and the related responses to the physiology of the uterine action. The intrapartum foetal monitoring is the primary responsibility of the midwives caring for the woman in labour. Midwives’ knowledge and understanding of CTG traces and interpretation ensure timely responses to pathological findings, thus ensuring positive foetal and neonatal outcomes.

Aim: The study aimed to assess the midwives’ knowledge of cardiotocograph interpretation and documentation in a selected hospital in Gauteng.

Setting: The data were collected in a selected secondary hospital, a referral hospital for the midwife-led obstetric units and district hospitals in the Gauteng province.

Methods: The study employed a quantitative retrospective research design, utilising a checklist to analyse patients’ past medical records – this retrospective analysis aimed to evaluate midwives’ knowledge in interpreting CTG.

Results: A review of 336 CTG case records analysed five criteria: baseline heart rate, variability, decelerations, accelerations, and overall trace assessment. Significant discrepancies in record-keeping were found between midwives and researchers. Researchers maintained complete records and interpretations for all criteria, whereas midwives exhibited considerable gaps, ranging from 31% to 100% across the CTG criteria.

Conclusion: Analysis indicates a substantial gap in CTG documentation by midwives compared to researchers.

Contribution: Midwives exhibiting significant data omissions that may affect intrapartum care quality and clinical decisions.

Prescribers’ experiences regarding deprescribing of polypharmacy at selected district hospitals in Gauteng province, South Africa

Thabiso R. Phoka — 2026-02-18

Background: Polypharmacy is a significant and persistent issue that hinders patient treatment plans and outcomes. It is associated with a wide range of harmful outcomes, including adverse drug interactions, increased morbidity and even mortality rates. The dire effects of polypharmacy have been associated with increased medication errors, hospitalisations, early readmissions and healthcare costs. Despite the extensive documentation and public awareness of these risks, little has been done to address the problem effectively. Deprescribing serves as a valuable strategy to mitigate and prevent the negative consequences associated with polypharmacy.

Aim: The study sought to explore and describe prescriber’s understanding and experiences regarding deprescribing of polypharmacy. Settings: The study was conducted at district hospitals in Gauteng province.

Methods: A qualitative, descriptive, exploratory and contextual research approach and design was applied in the research. Non-probability purposive sampling techniques were used to select prescribers. Eight steps of data analysis were followed to analyse the data.

Results: Three themes and nine sub-themes emerged from the study: (1) Negative effects of the impact of polypharmacy (the negative impact on the patients, the impact on prescribers and the impact on the organisation), (2) factors that hinder the deprescribing of polypharmacy (prescriber-related factors, patient-related factors, complexity of the prescribing environment and deficiencies in organisations) and (3) measures that can enhance deprescribing of polypharmacy (holistic systems for the deprescribing of polypharmacy and promotion of awareness and education).

Conclusion: This study concluded that prescribers currently believe deprescribing is a complicated process, and few of them actually engage with it. Deprescribing is a safe and effective way to manage inappropriate polypharmacy. This study recommended that improved interdisciplinary and multidisciplinary approaches among health practitioners be introduced to encourage deprescribing, which will avert polypharmacy in the district hospitals.

Contribution: The research findings provide insight, create awareness and encourage safe, rational and judicious prescribing practices among authorised prescribers in district hospitals in Gauteng province.

A qualitative exploration of psychosocial determinants influencing viral load suppression among adolescents living with HIV: Application of social action theory

Mathepe J. Thosago — 2026-02-18

Background: Adolescents living with HIV continue to experience poorer treatment outcomes than adults, with consistently lower rates of adherence and viral load (VL) suppression. This population faces unique developmental, social and emotional challenges that heighten their vulnerability.

Aim: This study aimed to explore the psychosocial determinants influencing VL suppression among adolescents living with HIV (ALHIV) in Mpumalanga province, South Africa, by applying the Social Action Theory (SAT).

Setting: The study was conducted at Mpumalanga province in South Africa.

Method: An explorative, descriptive qualitative design was used, and data were collected from September to November 2023. Data were collected through in-depth interviews using a semi-structured interview guide in a local language. Nineteen participants were interviewed. Thematic analysis was employed, and the theory of social action; context influences, process of social and self-change and states of action were followed to orient the findings.

Results: Six major themes, structured according to the SAT constructs, emerged, namely: Stigma and emotional distress hindering adherence and socio-environmental barriers to treatment consistency; Family and peer support promoting motivation for adherence and developing self-awareness and coping mechanisms; and lastly, Acceptance and responsibility towards treatment and formation of health-protective routines.

Conclusion: Adolescents who understand HIV diagnosis and understand the benefit of antiretroviral treatment are actively engaged in targeted behaviour and are influenced by beliefs about their abilities and potential outcomes rather than passively driven by external forces.

Contribution: There is a need for psychosocial support and monitoring from family members to help adolescents achieve the suppression of VL and to ensure adherence with antiretroviral therapy.

Integration of palliative care into South Africa’s health system: A before and after implementation study

Juanita O. Arendse — 2026-02-18

Background: Providing palliative care (PC) is an ethical obligation, and health systems must ensure access for all patients with life-limiting and life-threatening conditions. South Africa’s National Policy Framework and Strategy for Palliative Care mandates integration into public services.

Aim: To assess integration of PC services, previously neglected, before and 2 years after policy implementation.

Setting: South Africa’s Cape Metro District.

Methods: A cross-sectional descriptive study compared baseline (March 2019–June 2019) and follow-up (March 2021–June 2021) via desktop and document review. Fifteen documents and quantitative changes in deidentified morphine use, as a tracer for outpatient PC pain control, and International Classification of Diseases (ICD)-10 coding, as a proxy for PC service availability, were reviewed. Other key measures included financing (number of beds, funding per bed), planning and service delivery (care pathways, referral process).

Results: Palliative care was partially integrated into primary care. Indicators of policy adoption included an increased number of PC beds in intermediate care facilities, significant growth in healthcare professionals trained in PC and increased morphine usage in some sub-districts. However, integration remained uneven across the district.

Conclusion: Integrating PC into an already overburdened health system is challenging. Further integration of PC is needed, together with training tailored for diverse professionals. Effective practices in some subdistricts of the region, such as optimised morphine prescribing and streamlined referral pathways, could serve as models for subdistricts where integration is less advanced.

Contribution: The study documents positive changes following policy implementation and underscores the importance of strong project management and resource mobilisation for successful integration of complex services like PC.

From external rewards to intrinsic drive: A self-determination theory analysis of paramedic motivations for postgraduate educ

Naseef Abdullah — 2026-03-11

Background: Paramedicine research is expanding, yet non-paramedic researchers dominate knowledge production. This gap requires increased paramedic participation in postgraduate education to develop independent scholars and enhance discipline-specific research capacity.
Aim: To examine paramedics’ motivations for postgraduate education using selfdetermination theory (SDT).
Setting: The study utilised virtual platforms to engage South African-trained emergency care practitioners practising globally.
Methods: This qualitative study explored motivations among 51 paramedics from operational, academic, and management sectors in South Africa and internationally. Semi-structured interviews and focus groups were analyses using SDT as a framework.
Results: The study revealed that paramedics’ motivations for pursuing postgraduate education varied along a spectrum of regulatory styles, ranging from external regulation to intrinsic motivation. External regulation was driven by financial incentives and career
advancement opportunities. Identified regulations reflected personal recognition of education’s importance and qualification value. Integrated regulations demonstrated an alignment between education pursuits and personal beliefs or life goals. Intrinsic motivation was characterised by desires for professional growth and development.
Conclusion: The heterogeneous nature of paramedics’ postgraduate education motivation has significant policy and institutional implications. Traditional one-size-fits-all approaches may be ineffective.
Contribution: Educational institutions and professional development programmes should align initiatives with individual motivational profiles, emphasising autonomysupportive environments and connecting learning opportunities to personal values and professional aspirations to optimise engagement and outcomes.

Enhancing professional nurses’ preparedness and collaborative practices in managing gender-based violence: Insights from selected South African university campus health clinics

Siphesihle D. Hlophe — 2026-03-08

Background: Gender-based violence (GBV) is a critical public health issue, particularly in South African Higher Education Institutions (HEIs). This study explores professional nurses’ preparedness to manage GBV cases and identifies gaps in their formal training.
Aim: To examine professional nurses’ experiences and perceptions of their competence, interdisciplinary collaboration, and use of reporting, referral, and institutional resources in managing GBV at campus health clinics in HEIs.
Setting: Research was conducted at two universities, Institution One and Institution Two, focusing on professional nurses employed at campus health clinics.
Methods: An exploratory-descriptive qualitative design was used, with data gathered through semi-structured interviews with five professional nurses.
Results: Four themes emerged: (1) enhancing interdisciplinary collaboration through reporting and referrals; (2) challenges in managing GBV victims; (3) professional training and knowledge on GBV; and (4) nurses’ competence in handling GBV cases. This article emphasises themes one and four. Findings reveal the need for comprehensive GBV modules in nursing education and ongoing in-service training. Nurses reported challenges including limited victim information, systemic barriers and complex documentation.
Conclusion: Integrating GBV education into nursing curricula alongside continuous professional development and institutional support is essential to equip healthcare professionals to provide empathetic, comprehensive care to victims.
Contribution: This study offers insights for curriculum reform and policy development aimed at reducing GBV and promoting awareness and advocacy within HEIs.

Assessing the knowledge, practices and collaborative readiness of community pharmacists’ management of progressive joint disorders in South Africa

Tumelo Modau — 2026-03-11

Background: Progressive joint disorders (PJDs) are a leading cause of chronic pain and disability, requiring multidisciplinary management. Community pharmacists are well positioned to support patients through education, medication management and referrals, yet gaps in referral practices and interprofessional collaboration persist.
Aim: To assess South African community pharmacists’ referral practices in managing PJDs and their knowledge of other healthcare providers’ roles, with the goal of identifying opportunities to enhance collaboration and inform the development of referral guidelines.
Setting: Private community pharmacies across South Africa.
Methods: A cross-sectional survey was conducted using a structured online questionnaire distributed nationally. Data on demographics, familiarity with PJDs, management practices, referral behaviours and barriers to collaboration were analysed using descriptive and inferential statistics.
Results: Of 373 participants, 84.5% were familiar with PJDs, most commonly gout, osteoarthritis and rheumatoid arthritis. Over 60% did not use formal guidelines for PJD management. There was no significant association between guideline use and familiarity with other providers’ roles (p = 0.96). Referrals were predominantly to medical doctors with limited engagement with other health professionals. Barriers included a lack of referral protocols and limited knowledge of other providers’ roles. Most pharmacists expressed a willingness to improve care through better collaboration and education.
Conclusion: Pharmacists play a pivotal role in PJD management and require better training, awareness and structured referral pathways to enhance multidisciplinary care and optimise patient outcomes.
Contribution: This study highlights the need for evidence-based referral guidelines and interprofessional education in pharmacy curricula to strengthen pharmacists’ role in multidisciplinary PJD care.

Clinical pharmacists and drug-related problem management in a South African hospital

Mukonazwothe J. Luvhimbi — 2026-03-11

Background: Drug-related problems (DRPs) negatively impact health outcomes and are more likely in patients with multiple comorbidities and polypharmacy. Involving clinical pharmacists in multidisciplinary teams can improve drug safety and efficacy by preventing DRPs.
Aim: This study aimed to identify and analyse DRPs and highlight the role of clinical pharmacists in minimising DRPs.
Setting: This study was conducted in the internal medicine wards of a tertiary hospital in South Africa.
Methods: A descriptive quantitative study was conducted using purposive sampling, including all inpatients in internal medicine wards. Drug-related problems were identified through daily reviews of patient files using a standardised pharmaceutical care form. Findings were communicated to the healthcare team. Data were analysed descriptively using Stata.
Results: A total of 181 patient cases were reviewed, with most patients being male (65.2%) and aged 20–40 years (35.9%). A total of 241 DRPs were recorded, averaging 1.76 DRPs per patient. The most frequent DRP was failure to receive therapy (53.1%), often because of omitted doses. The clinical pharmacist made 277 recommendations, with 37.2% accepted by nurses and 22.7% by doctors.
Conclusion: Clinical pharmacists effectively identified and addressed DRPs, particularly omitted doses and therapeutic duplication. The integration of clinical pharmacists into healthcare teams can significantly reduce DRPs and enhance patient safety.
Contribution: This study raises awareness of drug-related problems and supports the development of strategies to prevent them in hospitalised patients.

Exploring occupational therapy interventions in homeless settings in Tshwane

Sarah Ainsworth — 2026-04-15

Background: In South Africa, the national lockdown was both a challenge and an opportunity to address health-related issues of homelessness. While initial emergency responses in Tshwane focused on basic needs and medical intervention, the need for more holistic intervention became evident.
Aim: To understand the experiences and perceptions, benefits and facilitators, and barriers and challenges of university-driven occupational therapy interventions with people experiencing homelessness in Tshwane during the various coronavirus disease 2019 lockdown levels and beyond to March 2023.
Setting: Research was conducted in various homeless settings, such as temporary shelters, transitional- or permanent housing facilities or drop-in centres, where occupational therapy intervention was implemented.
Methods: An explorative, descriptive qualitative design was used, with focus group discussions and semi-structured interviews conducted with people experiencing homelessness and homeless practitioners. These were audio recorded, transcribed and thematically analysed. Student-written occupational therapy planning and feedback documents were analysed through reflexive thematic analysis and interpreted using the Capability Approach.
Results: Inputs and conversion factors positively influencing intervention outcomes included a supportive environment, client-centred care, therapeutic activities in small groups, ensuring positive volition, and understanding the real-life experiences of participants. Challenges included unsupportive environments, language barriers, poor attitudes and motivation, and lack of continuity of occupational therapy intervention.
Conclusion: Occupational therapy intervention in homeless settings is valuable, as it considers personal, social and environmental aspects affecting a person’s functioning.
Contribution: Applying the unique contribution of occupational therapy intervention in homeless settings will improve overall health- and social service delivery.

Caught between rights and realities: Nurses’ challenges with upholding patients’ rights in selected health facilities of South Africa

Adolphina M. Thema — 2026-04-15

Background: Nurses play a central role in upholding patients’ rights; yet in many health facilities, these rights are frequently compromised. Understanding these challenges is essential for developing effective improvement strategies and ensuring ethical, patients’ rights-centred care in health facilities.
Aim: To explore and describe the challenges faced by nurses in upholding patients’ rights in selected health facilities within the Capricorn District, Limpopo province, South Africa.
Setting: The study was conducted in four health facilities, including a tertiary hospital, district hospital, clinic, and healthcare centre.
Methods: A qualitative, exploratory, descriptive, and contextual design was used. Data were collected through semi-structured interviews with 28 conveniently sampled nurses from different nursing categories. Data were analysed using Tesch’s open coding method.
Results: Three themes with six subthemes were identified: (1) resource deficiencies as barriers hindering nurses’ ability to uphold patients’ rights; (2) nurses’ difficulties in upholding patients’ rights in health facilities; (3) infrastructure constraints affecting nurses’ ability to uphold patients’ rights in health facilities.
Conclusion: The findings reveal that nurses’ ability to uphold patients’ rights is challenged by interrelated resources, patient-related, and infrastructure barriers. Addressing these challenges through adequate staffing, supply provision, infrastructure improvements, and supportive policies is critical for creating safe health facilities for patients.
Contribution: This study provides evidence to assist policymakers, educators, and health administrators in developing sustainable policies that maintain professional ethics and comply with the constitutional requirement for equitable healthcare. It underscores the need for policy reforms, better resourcing, and supportive environments to strengthen nurses’ capacity for rights-based, ethical, and patient-centred care.

Workplace incivility experienced by foreign national nurses in a Saudi Arabian hospital

Livhuwani S. Lavhengwa — 2026-04-15

Background: Workplace incivility is a persistent challenge in nursing. In Saudi Arabia, where foreign national nurses constitute a large part of the healthcare workforce, particularly in military hospitals, there is limited research on their experiences with workplace incivility and its effect on their well-being and patient care.
Aim: This study explored the factors influencing workplace incivility experienced by foreign national nurses in a Saudi Arabian military hospital and examined how these experiences impact their personal and professional well-being.
Setting: This study was conducted in the Southern Region of Saudi Arabia, in the province of Aseer. The study setting was the medical and surgical units in a military hospital.
Methods: A qualitative design using semi-structured interviews was employed with foreign national nurses. Purposive sampling ensured diverse representation across nationality, experience and clinical areas. Thematic analysis identified patterns, contributing factors, and perceived consequences of workplace incivility.
Results: Four subthemes emerged under organisational factors affecting workforce incivility and job satisfaction: ineffective leadership styles, discrimination among employees, poor employee engagement and empowerment, and lack of support from managers.
Conclusion: This study highlights the distinct challenges foreign national nurses face in Saudi Arabia’s healthcare context. The study contributes to evidence-based strategies for creating respectful, inclusive, and psychologically safe workplaces. The findings will inform hospital policies and support Saudi Arabia’s Vision 2030 healthcare reforms.
Contribution: By amplifying the voices of foreign national nurses, the study sheds light on socio-cultural, organisational, and legal factors influencing workplace incivility. Aligning with Vision 2030, the study offers practical guidance for fostering inclusive workplaces
and enriches theoretical and methodological understanding of incivility in multicultural healthcare settings.

Factors associated with medication adherence among hypertensive patients in Namibia

Daniel O. Ashipala — 2026-04-15

Background: Hypertension is a major public health concern, with non-adherence to treatment undermining disease management and control. In Namibia, little research exists on medication adherence among hypertensive patients, particularly in the Kavango East region, Namibia.
Aim: This study examined demographic, clinical, behavioural, and health system factors associated with medication adherence among hypertensive patients at a regional hospital in the Kavango East region, Namibia.
Setting: The study was conducted at the outpatient department of a regional hospital in northeastern Namibia.
Methods: A quantitative, cross-sectional approach was used with 200 hypertensive patients selected through consecutive sampling. Data were collected by using a self-administered questionnaire and analysed with Chi-squared tests and logistic regression to assess associations with adherence.
Results: Non-adherence to antihypertensive medications was common, with 62% (n = 124) reporting missed doses. Key reasons included forgetfulness (n = 112; 56%), side effects (n = 88; 44%), financial constraints (n = 74; 37%), transport barriers (n = 64; 32%), and poor knowledge (n = 52; 26%). Significant predictors of poor adherence included forgetfulness (adjusted odds ratio [AOR] = 0.39, p = 0.006), side effects (AOR = 0.42, p = 0.011), financial constraints (AOR = 0.40, p = 0.009), and transport difficulties (AOR = 0.44, p = 0.019). Employment (AOR = 0.52, p = 0.041) and living with hypertension for ≥ 5 years (AOR = 1.75, p = 0.047) were protective, while men were 1.48 times more likely to adhere than women.
Conclusion: Adherence to antihypertensive therapy is undermined by socioeconomic, behavioural, and health system barriers.
Contribution: This study provides much-needed evidence on the determinants of medication adherence in Namibia. It offers guidance for public health strategies, community awareness, and improved hypertension management outcomes.

Comparison of treatment outcomes of adolescents on HIV treatment before and during the coronavirus disease 2019 pandemic in Cape Town, South Africa: A retrospective cohort study

Nazreen Khan — 2026-04-15

Background: The coronavirus disease 2019 (COVID-19) pandemic disrupted healthcare systems, posing risks for adolescents living with HIV (ALHIV) in resource-limited, high HIVprevalence settings. These disruptions threatened antiretroviral therapy (ART) adherence,
viral load suppression (VLS) and retention in care (RiC).
Aim: This study aimed to compare treatment outcomes of ALHIV on ART in the Khayelitsha and Eastern Substructure (KESS) before and during the COVID-19 pandemic.
Setting: The study was performed in KESS, Cape Town, South Africa.
Methods: A retrospective cohort analysis was conducted among ALHIV aged 10–19 years receiving ART at public health facilities, pre-COVID-19 (before 01 March 2020) and during COVID-19 (01 March 2020–31 December 2021). Sociodemographic, clinical, and treatment data were analysed. Descriptive and inferential statistics compared outcomes and determined factors associated with VLS (< 1000 copies/mL) using SPSS v.30.
Results: Data from 1702 ALHIV (pre-COVID-19) and 2733 ALHIV (during COVID-19) were analysed. Viral load suppression declined from 82.1% to 64.8%, while full VLS (< 50 copies/mL) from 70.8% to 53.7% ( p = 0.065). Antiretroviral therapy adherence fell from 96.4% to 70.0% ( p < 0.001), and RiC 80.3% to 76.3% ( p < 0.001). In multivariate analysis, higher CD4 count, and consistent ART adherence predicted VLS.
Conclusion: Antiretroviral therapy adherence and VLS rates among ALHIV declined during COVID-19. Adolescent-centred healthcare delivery models are needed to ensure continuity of HIV treatment during public health emergencies.
Contribution: This study provides local evidence on the pandemic’s impact in a high-burden South African context. By quantifying declines in ART adherence, RiC, and VLS, it highlights ALHIV vulnerabilities and the need to strengthen adolescent-responsive, resilient healthcare systems.

Exploring psychological experiences of soldiers who have undergone voluntary male medical circumcision at the Engineers Battalion in Kasungu, Malawi

George Chapweteka — 2026-04-15

Background: Voluntary medical male circumcision (VMMC) has gained recognition for its potential to reduce the risk of HIV transmission. However, limited academic research has comprehensively examined the psychological experiences of individuals who have undergone this procedure.
Aim: The study aimed to explore the psychological experiences of soldiers who have undergone VMMC at the Engineers Battalion in Kasungu, Malawi.
Setting: The study was conducted at the Engineers Battalion in Kasungu, Central Region of Malawi.
Methods: A qualitative phenomenological study design was used. A purposive sampling strategy was used to enrol eight participants. A semi-structured interview schedule with probing questions was used to collect data. An interpretive thematic framework approach was used to analyse data.
Results: Immediate psychological experiences included heightened anxiety, vulnerability and physical discomfort. Short-term experiences involved challenges adapting to physical restrictions and feelings of self-consciousness. Long-term psychological experiences were characterised by a blend of positive self-perceptions.
Conclusion: The study highlights the mental health challenges associated with routine VMMC among an under-researched population in Malawi. Voluntary medical male circumcision significantly affects the psychological well-being of soldiers across various stages of recovery, underscoring the need to integrate psychological counselling and support into military health initiatives.
Contribution: Findings from this study will contribute to the growing body of knowledge on the intersection between VMMC, psychological well-being and military health policies, ultimately informing the design of tailored interventions to support circumcised soldiers in Malawi and beyond.

Exploring interprofessional education priority settings: Perspectives of Faculty of Health Sciences programme managers

Mpho J. Morule — 2026-04-28

Background: Transformational leadership is crucial for the support and sustainability of any interprofessional education (IPE) programme. This is because academic leaders are drivers at a macrosystem level, needed to use their influence to guide change and enable the necessary resources to support IPE.
Aim: To explore programme managers’ perspectives regarding priority settings related to IPE in the undergraduate health sciences training.
Setting: Health Sciences University in Gauteng, South Africa.
Methods: A qualitative, explorative study design was used. Primary data were collected through one-on-one interviews, and secondary data involved a targeted review of curriculum content. A thematic analysis was conducted using the Braun and Clark approach and a criterion checklist for curriculum content analysis.
Results: Interprofessional education seems to be covered broadly in certain schools and departments through the shared modules where students from different professions are taught together, and they work together on community projects. The importance of having committed staff members who are responsive to IPE was also identified as valuable resources for the implementation and success of IPE.
Conclusion: The results showed that IPE is implemented in certain schools or departments. However, challenges such as timetable constraints and a lack of IPE coordination could be improved to promote successful IPE implementation. Participants highlighted the need for administrative support across all schools or departments including a dedicated coordinator and flexible timetable to accommodate IPE-related activities.
Contribution: The study findings provide insights that can help to identify opportunities to strengthen the existing IPE activities and improve the implementation thereof.

Factors influencing husbands’ participation in antenatal care: A study in Maluku, Indonesia

Magdalena Paunno — 2026-04-29

Background: Husbands’ involvement in supporting standardised antenatal care (ANC) is essential for improving maternal and neonatal outcomes in geographically remote and socio-culturally complex settings. In Maluku, Indonesia, such involvement is shaped by limited-service access and entrenched cultural, religious and family power structures; yet their combined influence across pregnancy remains underexplored.
Aim: This study examined how service access, cultural and religious norms, family dynamics and knowledge influence husbands’ involvement in supporting standardised ANC in Maluku province, Indonesia.
Setting: The study was conducted in six remote primary health centres in Maluku province, Indonesia.
Methods: A sequential explanatory mixed-methods design was applied. Quantitative data were analysed using chi-square tests and multivariable logistic regression, while qualitative data from interviews and focus group discussions were thematically analysed. Data were collected from January 2024 to June 2024.
Results: Only 27% of husbands actively supported standardised ANC. Supportive roles (adjusted odds ration [AOR] = 25.2; p = 0.039), positive family dynamics (AOR = 2.7; p = 0.005) and higher ANC knowledge (AOR = 10.7; p = 0.024) were independently associated with involvement. Qualitative findings showed predominantly passive participation shaped by culturally sanctioned authority, religious legitimacy and community influence.
Conclusion: Husbands’ limited involvement reflects gaps in knowledge, as well as the influence of family decision-making structures and socio-cultural norms. Integrating local wisdom (Bakele) into a culturally grounded, trimester-based antenatal counselling model may enhance participation.
Contribution: This study informs culturally adapted ANC interventions in remote and socio-culturally complex settings.

Factors affecting the implementation of the Health Extension Workers Programme in Kavango East Region, Namibia

Dionisius M. Nghikevali — 2026-04-29

Background: The Namibian Health Extension Workers Programme (HEWP) plays a crucial role in ensuring equitable access to healthcare, particularly in rural areas. Little research exists on the factors affecting the implementation of HEWP; however, there is an urgent need for these services.
Aim: To explore and describe the factors affecting the implementation of the HEWP in Rundu District, Kavango East Region, Namibia.
Setting: The study was conducted at the five primary health care clinics in the Rundu District, Kavango East region of Namibia.
Methods: An exploratory descriptive qualitative research design was employed. The population consisted of 28 health extension workers (HEWs). Data saturation was reached with 13 participants; two more participants were added, bringing the total to 15, and no new information emerged. Data were collected through semi-structured interviews using an audiotape recorder and field notes before being analysed thematically using Braun and Clarke’s six steps of data analysis. Trustworthiness was ensured using Lincoln and Guba’s four criteria. Ethical approval was obtained from the School of Nursing Research Committee, with the principles of beneficence, autonomy, justice and non-maleficence being adhered to.
Results: Three prominent themes emerged: Organisational and resource-related factors affecting HEWP implementation; HEWs’ capacity and engagement; and recommendations to ensure the effective implementation of the HEWP.
Conclusion: The findings revealed that there are several barriers that need to be overcome before the desired outcome of HEWP can be successful. Major obstacles to programme implementation include insufficient resources, excessive staff turnover and inadequate training.
Contribution: The results of this study can be used to develop targeted interventions and strategies to mitigate the factors encountered during the implementation of the HEWP in Namibia and similar settings.

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Parents’ and teachers’ perspectives on the barriers to spectacle uptake among learners in the Free State, South Africa

Xolani Nyathela — 2026-06-10

Background: Parents’ and teachers’ awareness of their children’s visual challenges is critical in curbing the deleterious effects of uncorrected refractive errors (UREs), especially on their learning capabilities.

Aim: This study aimed to determine the barriers to the uptake of spectacles according to the parents or guardians and teachers of high school learners in the Free State province.

Setting: Free State province, South Africa.

Methods: A quantitative, descriptive, cross-sectional study using a survey method was conducted among teachers and parents of learners diagnosed with UREs during earlier phases of the research, which are not reported in this publication. Participants self-administered questionnaires adapted to the Free State province.

Results: A total of 132 parents and 23 teachers participated in this study. Red eyes were identified as an eye-related problem by 20.5 % parents and 39.1 % teachers, double vision by 24.2 % parents and 30.4 % teachers, while tearing eyes was identified by 30.4 % parents and 39.1 % teachers. About 60 % parents did not know how far optometrists were, 55.7 % were unemployed, and 3.8 % had healthcare insurance. Only 8.8 % and 4.4 % of teachers associated spectacle wear non-compliance with lower self-confidence and poorer academic performance, respectively. A total of 9.1 % parents and 8.7 % teachers perceived spectacles as bad for the eyes. Also, 68.2 % parents had never taken their children for an eye examination before.

Conclusion: Parents’ and teachers’ lack of awareness and/or knowledge of eye-related problems adversely impacted the uptake of spectacles. Contribution: The affordability, availability, and accessibility of eye care services presented as obstacles to the uptake of spectacles for parents.

Agency as a catalyst in pulmonary rehabilitation implementation: Physiotherapists’ perspectives

Lisa Labuschagne — 2026-04-29

Background: Chronic respiratory diseases (CRDs) are a major global health burden, and pulmonary rehabilitation (PR) is a well-established, evidence-based intervention that improves functional capacity and quality of life for persons affected. Despite this, access to PR is limited globally and within South Africa. Insight into how PR programmes (PRP) are established and sustained in practice may help explain the persistence of this implementation gap.
Aim: To explore physiotherapists’ experiences of establishing outpatient PRP in the Cape Metropole.
Setting: The study included public and private physiotherapists in the Cape Metropole, Western Cape Province, South Africa.
Methods: An exploratory qualitative descriptive design was employed using semi-structured interviews with six physiotherapists who had attempted to establish outpatient PRP. Data were analysed using reflexive thematic analysis, with Social Cognitive Theory informing interpretation of interactions between environmental conditions, clinician agency and programme outcomes.
Results: Three interrelated themes were identified. Firstly, practice contexts, including funding structures, referral systems, organisational support and physical resources, shaped the feasibility of PRP. Secondly, clinician agency, expressed through motivation, self-efficacy, advocacy and adaptive capacity, influenced how physiotherapists navigated these contextual conditions. Thirdly, PRP followed divergent trajectories over time, with outcomes more predominantly shaped by how individual physiotherapists interpreted early experiences and feedback rather than by context alone.
Conclusion: PRP implementation was shaped by dynamic interactions between contextual conditions and clinician agency. Participants faced similar challenges, however differences in their agency influenced whether PRP were sustained, adapted or remained partial. Strengthening physiotherapists’ self-efficacy, behavioural capability and access to mentorship may support more sustainable PR provision in contexts where services remain limited.
Contribution: This study highlights clinician agency as a critical mechanism in PR implementation and suggests that interventions to expand PR services should address both structural barriers and the development of physiotherapists’ adaptive capacity.

Social workers’ motivation to provide effective service in a challenging environment of illegal substance abuse

Oratile Khampepe — 2026-06-10

Background: The social work profession is portrayed as a stressful occupation that brings about depression and demoralisation upon social workers. It is believed that working towards changing an individual, group or community at large is difficult.

Aim: To explore the gratification that social workers receive from working with youth abusing substances.

Setting: Data were collected from social workers employed by the Department of Social Development, from both the Sebokeng and Vereeniging offices, as well as the South African National Council on Alcoholism and Drug Dependence in the Vaal Triangle area.

Methods: This qualitative and phenomenological study was undertaken with a sample of 15 participants who were selected through purposive sampling. Data were gathered through semi-structured interviews and analysed thematically.

Results: The study highlights the significance of creating a supportive work environment to maintain good performance and well-being amongst social workers in the substance abuse or misuse section.

Conclusion: Many studies record the struggles that social workers endure when rendering services to the youth, adolescents and other groups abusing illegal substances; yet some find gratification when rendering services, which is not recorded.

Work experiences and practices of radiographers during the coronavirus disease 2019 pandemic: Future pandemic preparation

Nkole Bwalya — 2026-04-29

Background: During the peak of the coronavirus disease 2019 (COVID-19) pandemic, radiographers in Zambia faced heavy workloads as chest X-ray referrals outpaced staffing and the capacity of X-ray imaging equipment, and protective gear was limited. The pandemic disrupted the daily work routines of radiographers, yet little is known about how radiographers in Zambia experienced and thrived through this public health crisis.
Aim: This study aimed to determine the work experiences and practices of radiographers during the COVID-19 pandemic for future reference.
Setting: Two tertiary hospitals are designated as COVID-19 treatment centres in the Eastern province of Zambia.
Methods: A qualitative approach with exploratory and descriptive designs was employed. A purposive sample of 11 radiographers was used for interviews to reach data saturation. The time frame for data collection was from 01 November 2023 to 30 November 2023. Data were collected through semi-structured face-to-face interviews and were analysed thematically using Braun and Clarke’s method.
Results: Four themes were developed, namely: (1) personal and work-related challenges, (2) adapting to abrupt changes, (3) wellness and information support and (4) preparation for future pandemics.
Conclusion: Radiographers adapted and demonstrated resilience to the high occupational pressures of patient referrals for chest X-ray imaging during the pandemic, although they were fearful of contracting the COVID-19 infection.
Contribution: This article adds strategies to improve emergency X-ray imaging response and strengthen preparedness for future health emergencies, informed by radiographers’ COVID-19 experiences.

Improving employment retention at a North West province nursing college: Perceptions of nurse educators

Ernest H. Mbolongwe — 2026-04-29

Background: High nurse educator turnover rates necessitate the need for nursing colleges to explore the retention of nurse educators. The views of nurse educators were sought to generate contextually informed insight into improving retention.
Aim: To explore and describe the perceptions of nurse educators working at a public nursing college in North West, South Africa, on improving retention of nurse educators.
Setting: The research was conducted at two campuses of a public nursing college in the North West province.
Methods: A qualitative descriptive design was used to explore and describe the perceptions of nurse educators in providing answers to the research question. Typical purposive sampling was used by applying selection criteria. Focus group interviews were conducted, and conventional content analysis was applied. Data saturation was reached after conducting four focus group interviews, with a total of 29 participants, divided as follows: Campus A: two groups of eight participants each, Campus B: one group with six participants and one group with seven participants.
Results: Five categories with sub-categories emerged, namely: (1) improving the working environment contributes towards retention, (2) improving human resource management, (3) better remuneration and benefits, (4) positive aspects of staying in nursing education and (5) eliminating politics and mismanagement.
Conclusion: This study on the views of the nurse educators acknowledges their voices, ensuring that the matter of retention can be informed by those directly situated within the phenomenon.
Contribution: The study provides insight into the views of nurse educators regarding employment retention, namely that the work environment – including the physical environment, human resource management, remuneration and benefits and political influence and mismanagement – as well as nurse educators’ passion for what they do, influences their decision to leave or to stay in employment. These insights are valuable for tailoring retention strategies and provide a solid grounding for further research on the employment retention of nurse educators.

Experiences and coping behaviours of clients with sexually transmitted infections in Malawi

Thandie Munthali — 2026-06-10

Background: Sexually transmitted infections (STIs) remain a significant public health challenge in Malawi, affecting millions of people every year. Despite the availability of effective treatments, STIs can have a significant impact on the well-being of those infected.

Aim: The study aimed at exploring the lived experiences and coping behaviours of clients attending the STIs clinic at Mzuzu Urban Health Centre.

Setting: Urban Primary Health Centre in Mzuzu.

Methods: A qualitative approach with a descriptive phenomenological design was used in this study. Ten participants were purposively selected. A semi-structured interview guide was used to collect information on demographics, experiences and coping behaviours. Data collected was thematically analysed.

Results: Lived experiences were emotional strain on relationships, feelings of fear, Stigma and discrimination from the community, uncertainty about the future, anxiety and depression symptoms of the disease. However, adaptive coping behaviours were to seek comfort in close family members and friends and intrinsic personal motivation. While maladaptive coping behaviours were utilising traditional practices on the genitalia, and avoidance behaviours.

Conclusion: Individuals with STIs predominantly face psychological experiences, concerns about fertility, with economic worries, often worsened by the link to HIV. Understanding the experiences and their coping strategies can help healthcare providers to intensify public awareness and health education on the treatment of STIs. Additionally, integration of mental health interventions for more personalised, holistic care is crucial.

Midwives’ views on implementation of antiretroviral clinical guidelines for the prevention of HIV in a private hospital

Tshegofatso E. Chauke — 2026-06-10

Background: South Africa has made considerable progress in HIV and AIDS management, particularly in vertical transmission prevention (VTP). The 2023 national HIV guidelines, which includes provision for pregnant and breastfeeding women, mark an important advancement. However, implementation in the private healthcare sector remains uncertain. The effective application of antiretroviral therapy (ART) guidelines in maternity wards within private hospitals is essential to prevent vertical transmission of HIV.

Aim: This study explored midwives’ perspectives on the implementation of ART clinical guidelines for preventing vertical HIV transmission in maternity wards within a private hospital in Gauteng province.

Setting: The study was conducted in a maternity ward of a private hospital in the Tshwane District, Gauteng, South Africa.

Methods: A qualitative, exploratory, descriptive design was used. Thirteen purposively selected midwives participated in in-depth, semi-structured interviews, which were audio-recorded with consent, transcribed verbatim and thematically analysed to develop themes.

Results: Four themes emerged: (1) Lack of standardised practice in implementing VTP guidelines; (2) Ethical and confidentiality challenges; (3) Limited role of midwives in VTP management; and (4) Strategies to enhance implementation and use of ART clinical guidelines in private hospitals.

Conclusion: The findings highlight challenges in implementing ART guidelines in private maternity settings and emphasise the need for stronger integration of national HIV guidelines through training, policy alignment and institutional support to improve maternal and neonatal outcomes. Contribution: The study presents recommendations for strengthening the role of private hospitals in reducing vertical HIV transmission and supporting HIV and AIDS elimination goals.

Determinants of cultural intelligence and cultural competence among undergraduate nursing students in Namibia: A multicampus study

Nestor Tomas — 2026-06-10

Background: In an increasingly globalised world, healthcare professionals encounter a diverse range of patients, making it essential for nursing students to be culturally intelligent and culturally competent. However, this area remains understudied in Namibia.
Aim: To assess and describe the determinants of cultural intelligence (CQ) and cultural competence among undergraduate nursing students at two university campuses in Namibia.
Setting: Two satellite university campuses in Namibia.
Methods: A quantitative descriptive design with a purposive sample of 215 undergraduate nursing students was employed between May 2024 and July 2024 using the Cultural Intelligence Scale (CQS) and the Nursing Cultural Competence Scale (NCCS) online questionnaires. Data were analysed using SPSS v29.
Results: Cultural competence had the highest average score (3.630 ± 1.150), followed by behavioural cultural intelligence (3.480 ± 1.010). A moderately significant correlation was observed between cultural competence and the behavioural dimension (r = 0.448; p < 0.001) and between motivation and the cognitive dimension (r = 0.310; p < 0.001). Four factors – behavioural cultural intelligence, cognitive, motivational and cultural competence – accounted for 47.62% to 61.17% of the total variance.
Conclusion: Nursing students demonstrated strong capabilities in both the behavioural and motivational aspects of cultural intelligence, as well as in cultural competence. These findings are valuable for developing nursing curricula to train culturally intelligent and competent practitioners. Future studies should focus on tool refinement.
Contribution: While refinement is required for the metacognitive subscale, the study contributes to the body of literature pertinent to curriculum design.

Nurses’ knowledge of hypertension care and associated factors in the Northern Region of Ghana

Sylvia P. Adzitey — 2026-06-10

Background: Hypertension is the main risk factor for cardiovascular-related morbidities and mortalities. Nurses play a pivotal role in hypertension care, encompassing screening, detection, management, patient education and self-management counselling.
Aim: This study assessed nurses’ knowledge of hypertension care and associated factors in the Northern Region of Ghana.
Setting: Tamale Metropolis of the Northern Region of Ghana.
Methods: A descriptive cross-sectional study was conducted among nurses. Using a census approach, 410 eligible nurses working in hypertension care across the study hospitals were invited to participate. Of these, 266 consented and completed a self-reported validated questionnaire. The IBM Statistical Package for the Social Sciences programme version 30 was used to process the data and perform descriptive and inferential statistics.
Results: The mean hypertension care knowledge score was 51.47% ± 11.76%. About 4% had good knowledge, 57.1% average knowledge, and 38.7% had poor knowledge. While nurses demonstrated good knowledge of accurate blood pressure measurement (82.4%), their knowledge of hypertension diagnosis (35.1%) and management (48.8%) was poor. The following were significantly associated with overall knowledge of hypertension care: hospital of practice (p = 0.021), age (p = 0.007), nursing category (p = 0.002), qualification (p = 0.001), years of practice in the present unit (p = 0.021) and hypertension in-service training (p = 0.027).
Conclusion: This study revealed significant gaps in nurses’ knowledge of hypertension care and highlighted the need for continuous professional development to bridge knowledge gaps and sustain clinical competence.
Contribution: The study provided evidence on nurses’ knowledge of hypertension care in Ghana, which can inform the development of tailored interventions to improve management and patient outcomes.

Paramedic mental health literacy and psychiatric emergencies: A qualitative pilot study in Gauteng, South Africa

Arshaad Boomgaard — 2026-06-10

Background: Paramedics in South Africa frequently respond to psychiatric emergencies in complex, high-risk pre-hospital environments. Their care is shaped by limited formal training, workplace cultures and varying mental health literacy, alongside legal, ethical and contextual constraints specific to emergency medical services. Despite these demands, little research has examined paramedics’ perceptions, attitudes and experiences of psychiatric emergencies in South Africa.
Aim: To explore paramedics’ perceptions, attitudes and experiences of psychiatric emergencies and how they influence assessment, communication and decision-making in the pre-hospital setting.
Setting: Paramedics working in private and public emergency medical services in Gauteng, South Africa.
Methods: An exploratory qualitative design was employed. Semi-structured interviews were conducted with eight paramedics across Basic, Intermediate and Advanced Life Support levels. Data were analysed using inductive thematic analysis to identify patterns across participants’ accounts.
Results: Five themes were identified. Participants described limited formal training in psychiatric emergency care, resulting in reliance on experiential learning and peer modelling. Communication and de-escalation were viewed as essential but inconsistently supported by training and resources. Workplace humour, stigma and emotional distancing were commonly described as coping responses, with divergent views regarding their impact on patient care. Ethical and legal uncertainty shaped conservative or coercive decision-making around consent, restraint and sedation. Cultural, linguistic and environmental factors complicated assessment and engagement.
Conclusion: Despite commitment to supporting psychiatric patients, significant educational and structural gaps constrained effective care. Enhanced training, reflective supervision and context-sensitive guidance may improve patient experiences and paramedic decision-making.
Contribution: This study contributes to understanding how South African paramedics perceive and manage psychiatric emergencies in pre-hospital settings, highlighting educational, ethical, and contextual challenges influencing care.

Factors influencing treatment default among patients initiated on antiretroviral at a district in the North West province of South Africa: A qualitative study

Mmalebone R. Ntantiso — 2026-06-10

Background: People living with HIV who default on antiretroviral therapy pose a significant global and local health challenge, and South Africa is not immune to this challenge.
Aim: This study explores factors influencing treatment default among patients receiving antiretroviral treatment in one district of North West province, South Africa. The study proffers recommendations to address default among patients initiated on anti-retroviral treatment.
Setting: A clinical setting in the North West province, South Africa.
Methods: A qualitative exploratory, descriptive and contextual research design was adopted. Purposive sampling was used to select potential participants. The population consisted of patients who defaulted on antiretroviral treatment and were registered at a specific primary healthcare facility. The sample size was determined by data saturation. Consequently, 12 participants who had defaulted on antiretroviral treatment for 3 months or more were interviewed. Data were collected through face to face, unstructured, in-depth individual interviews, field notes and an audio recorder. All ethical principles were followed throughout the study. Tesch’s method of analysis and open coding were employed to analyse the data.
Results: Patients default on antiretroviral treatment for various reasons, including a deficient healthcare system marked by overcrowding and negative staff attitudes. Personal issues, unemployment and life partners emerged as reasons for default.
Conclusion: Various factors influence the default on antiretroviral treatment, including access to healthcare facilities.
Contribution: This study adds new knowledge about best nursing practices for managing patients who default on antiretroviral treatment.

Exploring the strategies used by managers to support midwives experiencing adverse events in a selected district of Gauteng province

Rebotile V. Morobe — 2026-06-10

Background: Globally, adverse events (AEs) remain a major patient safety concern, as they are unintended injuries resulting from healthcare management rather than from the patient’s condition. Managerial support is essential to help midwives cope. Limited research exists on strategies that managers use to support midwives following AEs.
Aim: To explore and describe strategies used by managers to support midwives who experience AEs in obstetric units of selected district in Gauteng province.
Setting: Three public hospitals in Gauteng province, South Africa.
Methods: Qualitative, exploratory, descriptive and contextual design was used. Twelve managers were purposively selected through non-probability sampling. Data were gathered using semi-structured interviews, lasting 30 min – 45 min. A pilot study conducted tested
interview process and analysed using Tesch’s coding.
Results: Findings revealed three themes and six sub-themes. Support included assistance with incident reporting; assessment of AEs; creation of supportive work environment; provision training; emotional support; and follow-up sessions.
Conclusion: Managerial support is critical in mitigating emotional and professional impact on midwives. A 24-hour counselling service was recommended.
Contribution: This study provide evidence on managers’ support strengthening emotional and professional systems. The findings will improve policies, leadership practices and training of midwives.

Functional outcomes post-stroke: Evidence from private rehabilitation facilities in South Africa between 2006 and 2023

LeeAnne Masilela — 2026-06-10

Background: Effective rehabilitation is crucial for stroke survivors to regain functional independence and reduce the healthcare burden associated with disability and hospital readmission.
Aim: To evaluate the functional outcomes in patients with stroke at private rehabilitation facilities between 2006 and 2023.
Setting: This was a retrospective cohort study of 9010 patients, post-stroke, at private rehabilitation facilities registered with the South African Board of Healthcare Funders.
Methods: The 7-point BETA scale was used to measure inpatients’ ability to perform Activities of Daily Living (ADL) in real time. Secondary analysis was conducted on ADL data sets (N = 9010) from a purposive sample of private rehabilitation facilities (n = 47). Descriptive statistics were used to determine the median functional scores of stroke patients measured by the BETA scale. Linear regression was used to compare functional gain scores by baseline patient demographics, and logistic regression for the association between functional deterioration and patient factors, and to predict risk.
Results: Functional outcomes showed limited improvement; 40.8% of inpatients experienced deterioration, 19.5% showed no functional gain, 31.9% showed modest gain, and a small minority (< 0.5%) achieved substantial functional gains. Predictors of functional outcomes included age, gender, racial demographics, facility type and stroke characteristics.
Conclusion: The findings indicate suboptimal functional outcomes in patients, post-stroke, at private rehabilitation facilities. There is a need for targeted improvements in rehabilitation practices and policy changes to enhance post-stroke functional outcomes.
Contribution: This study provides longitudinal perspectives of patients’ functional outcomes post-stroke in private rehabilitation facilities and an evidence base for informing rehabilitation practice improvements.

Implementing a balanced scorecard-driven performance dashboard for governance in a public oncology centre in Morocco

Ismail Bejja — 2026-06-10

Background: Cancer care in low- and middle-income countries (LMICs), including Morocco, is constrained by fragmented information systems, non-standardised indicators and limited integration of clinical, financial and administrative data. These weaknesses
undermine governance capacity, impair care coordination and delay evidence-informed decision-making.
Aim: To co-design and implement a balanced scorecard (BSC)-based digital performance governance model in a public university oncology centre in northern Morocco.
Setting: The study was conducted at a public tertiary oncology centre integrated into Morocco’s National Cancer Control Programme.
Methods: A qualitative participatory action research (PAR) design was used. Multidisciplinary workshops and semi-structured interviews supported the development of a BSC framework and the validation of 21 performance indicators across five perspectives: clinical results, financial sustainability, patient experience, internal processes and learning and growth. Patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs) were integrated into a digital dashboard. Descriptive statistics and thematic analysis were conducted within the PAR and BSC framework.
Results: Operational indicators, including treatment completion and equipment utilisation, were high (≈90%), reflecting strong technical capacity. Diagnostic delays and late-stage presentation remained frequent. Patient-centred processes were weaker: satisfaction with care coordination and supportive services was suboptimal, and coverage of psychosocial and nutritional support was limited. Learning and growth indicators showed moderate staff training and restricted access to innovation.
Conclusion: The BSC-based digital model improved transparency, coordination and strategic alignment, representing a replicable and contextually adaptable governance approach for oncology services in LMICs.
Contribution: This study provides a replicable framework linking clinical performance, patient experience and organisational learning.

Associations between school backpack loading, sitting time and low back pain among schoolchildren in Gaborone, Botswana

Ngonidzaishe B. Mudiwa — 2026-06-10

Background: Low back pain (LBP) is increasingly reported among school-aged children, a population vulnerable to musculoskeletal strain as a result of growth-related changes, developing spinal structures and school demands such as heavy backpacks and prolonged sitting. Although international evidence highlights these risk factors, data from African contexts, particularly Botswana, remain limited.
Aim: This study investigated associations between school backpack loading, sitting time and the prevalence and intensity of LBP among 10–12-year-old schoolchildren.
Setting: Primary schools in Gaborone, Botswana.
Methods: A cross-sectional study was conducted among 521 children (46% boys; mean age = 11.1 ± 0.7 years). Backpack and body mass were measured using calibrated scales, and sitting time was self-reported using the International Physical Activity Questionnaire – Short Form (IPAQ-SF). Low back pain frequency and intensity were assessed using the Young Spine Questionnaire (YSQ). Chi-square tests examined associations between LBP outcomes and independent variables, and Cramér’s V interpreted effect sizes.
Results: Approximately 43% carried backpacks exceeding 10% of body mass; 34% reported frequent LBP and 14% moderate-to-severe intensity. Heavier loads were weakly but significantly associated with more frequent LBP (χ² = 4.05; p = 0.044; Φ = 0.09). No associations were found with sitting time, age or sex.
Conclusion: Heavier backpack loads were associated with higher LBP frequency among Gaborone schoolchildren, although the effect size was small. These findings highlight the importance of addressing modifiable ergonomic factors, particularly load management, in school health strategies.
Contribution: This study highlights modifiable ergonomic risk factors for LBP in Botswana and supports the inclusion of load management and posture education in school health programmes.

Prevalence of overweight, obesity and central adiposity among grade seven adolescents in urban Tshwane, South Africa

Nonie M. Mokose — 2026-06-10

Background: The global increase in overweight and obesity among adolescents is a significant public health priority, especially in low- and middle-income countries. In South Africa, urbanisation and lifestyle changes have exacerbated this challenge, but there is a lack of disaggregated data available to inform effective local responses.
Aim: To assess and describe the prevalence of overweight, obesity and central adiposity in Grade seven adolescents in urban Tshwane, South Africa, and explore its association with socioeconomic characteristics.
Setting: The study was conducted in five diverse fee-paying public primary schools in urban Tshwane, Gauteng province.
Methods: A quantitative, descriptive cross-sectional design recruited 164 adolescents aged 11–14 years. Anthropometric measures were performed according to World Health Organization (WHO) standards. These included a survey of height and weight to derive body mass index (BMI-for-age) z-scores, as well as waist circumference to height ratio (WHtR). Socioeconomic status was assessed using the validated Family Affluence Scale. Data analysis included descriptive statistics and chi-square tests to determine the association between categorical variables.
Results: The combined prevalence of overweight and obesity was 23.7%, with a greater burden among girls (36.4% of 12 year olds) compared to boys (16.7%). The risk of central adiposity (WHtR ≥ 0.5) was found in 25% of participants, with 7.3% at very high risk. Household income was significantly associated with obesity (p = 0.043), while parental education was not statistically significant.
Conclusion: The high prevalence of excess adiposity, particularly among female adolescents, indicates an emerging cardiometabolic risk profile among the group.
Contribution: This study addresses a critical gap in South African public health literature by providing locally specific, disaggregated data on the nutritional status of urban adolescents in Tshwane, a cohort that is underrepresented in contrast to conventional rural or national surveys.

Perceptions of Emergency Medical Care students on high-fidelity manikins versus standardised patients: Insights from a pilot mixed-methods study

Karien Henrico — 2026-06-10

Background: Simulation-based education is central to Emergency Medical Care (EMC) training, particularly in preparing students for high-pressure, pre-hospital environments. High-fidelity manikins (HFMs) and standardised patients (SPs) are widely used simulation
modalities; however, comparative evidence from low- to middle-income countries remains limited. Understanding student satisfaction with these modalities is important for ensuring educational quality and making informed resource allocation.
Aim: This study explored EMC students’ satisfaction with HFMs and SPs to inform pedagogical and resource-related decisions.
Setting: The study was conducted in a university-based simulation laboratory at a South African higher education institution.
Methods: A pilot mixed-methods design was employed. Fifteen first-year EMC students completed the same clinical simulation scenario using both a SP and a HFM. Satisfaction was measured using a revised Satisfaction Scale for High-Fidelity Clinical Simulation and two open-ended questions. Quantitative data were analysed descriptively, and qualitative responses were analysed thematically.
Results: High levels of satisfaction were reported for both simulation modalities. Standardised patients received higher satisfaction scores for realism, theory-practice integration and self-confidence, while HFMs were rated more favourably for practising technical skills and learning from mistakes. Qualitative findings indicated that SPs enhanced realism and engagement but were associated with increased stress.
Conclusion: Despite the small cohort, clear preferences and educational implications emerged. The findings support the use of blended simulation approaches and highlight the need for further, larger-scale research.
Contribution: This study provides preliminary evidence to inform simulationbased curriculum design and resource allocation in EMC education within resource-constrained contexts.

Utilisation of digital educational technology amongst undergraduate nursing students in the Western Cape

Million Bimerew — 2026-06-10

Background: Despite increased integration of digital technologies in higher education, nursing students face major barriers in resource-limited settings.
Aim: The study investigated the utilisation of digital educational technologies amongst undergraduate nursing students in the Western Cape.
Setting: The study was conducted at the school of nursing at a higher education institution in the Western Cape.
Methods: A descriptive cross-sectional survey design with a self-administered questionnaire was used to collect data from a sample of 253 participants. Descriptive analysis was conducted to determine the frequencies and percentages; the mean score and Chi-square test were conducted to determine the association between the variables.
Results: Nearly 90% of participants had experience in the use of digital educational technology, 94.5%, learning management system and Facebook, and 93.7% used PowerPoint, communication and collaboration tools. The gender differences in technology use are consistent with the literature. The results suggest female respondents’ frequent use of social networks. Male respondents reported more frequent use of bibliographic and web conferencing technologies. Although overall use was very low, gender remains an important factor in understanding technology use. In contrast, blogs, discussion forums and immersive technologies were amongst the least utilised educational technologies.
Conclusion: Most nursing students use basic digital tools like learning management systems, Facebook and PowerPoint, but advanced tools such as blogs, forums and immersive technologies are underused, revealing a gap in digital competence that limits collaborative learning and clinical simulation.
Contribution: This study provides evidence on digital technology use amongst undergraduate nursing students, showing frequent use of basic tools but limited engagement with advanced, interactive technologies.

Nurses’ and managers’ perceptions of quality nursing care in public hospitals in Ghana

Ba-Etilayoo Atinga — 2026-06-10

Background: Quality improvement is a global healthcare priority. In Ghana, consistent delivery of high-quality nursing care remains challenging, and the perspectives of nurses and nurse managers are often underrepresented in discussions on care quality. Exploring these perspectives is essential to inform practice, management and policy.
Aim: This study explored nurses’ and nurse managers’ perceptions of quality nursing care in public hospitals in the Bono Region of Ghana.
Setting: The study was conducted at three public hospitals in Ghana.
Methods: A qualitative, exploratory–descriptive design was adopted. Semi-structured face-to-face interviews were conducted with 18 professional nurses and three nurse managers purposively selected from three public hospitals. Data were analysed thematically using Tesch’s method, guided by Creswell’s qualitative data analysis framework.
Results: Three themes emerged: (1) attributes of quality nursing care, including individualised, ethical and evidence-based practice; (2) barriers to quality care, such as inadequate resources, limited supervision and negative staff attitudes; and (3) the impact of nursing care on patient outcomes and healthcare delivery. Interpersonal relationships and organisational constraints were found to influence care quality.
Conclusion: Quality nursing care is underpinned by clinical competence, ethical practice, teamwork and institutional support. Gaps in these areas compromise patient outcomes and staff satisfaction. Strengthening professional development, ethical standards, collaboration and organisational support is essential to enhance care quality.
Contribution: This study provides context-specific insights into quality nursing care from the perspectives of nurses and nurse managers in Ghana, contributing evidence to inform nursing management practices, policy development and quality improvement initiatives in similar resource-constrained settings.

Clients’ perceptions of nursing care services at selected public health facilities in Namibia: A qualitative study

Nestor Tomas — 2026-08-06

Background: Satisfaction is a subjective phenomenon that is influenced by various contextual factors. In the healthcare sector, establishing a therapeutic relationship with patients is essential for facilitating active, mutual engagement and fostering collaboration. However, patient satisfaction with nursing care services in Namibia remains under-researched.
Aim: The study explored and described clients’ perceptions of nursing care services at selected public health facilities in Namibia.
Setting: The study was conducted at two public health facilities in Namibia.
Methods: An exploratory, descriptive qualitative design was utilised to recruit 13 clients for individual interviews through purposive sampling. Data were collected in 2022 using an interview guide and analysed using Braun and Clarke’s six-step thematic analysis.
Results: Two key themes emerged: (1) nurse–client communication dynamics, encompassing clients’ views on client satisfaction, and (2) innovative client suggestions for enhancing client satisfaction, detailing measures to address identified challenges.
Conclusion: The study’s findings underscore the need to implement targeted training initiatives for nurses and to adopt client-centred care models. Future research should explore client satisfaction through larger cross-sectional or longitudinal studies to inform strategies to enhance client satisfaction with nursing care.
Contribution: The study provides valuable insights into client satisfaction and has implications for nursing practice in Namibia.

Patient satisfaction with private optometry service in South Africa

Tinyiko P. Hlungwani — 2026-08-06

Background: Patient satisfaction plays a vital role in the healthcare sector, holding significance for both medical providers and patients.
Aim: The study investigated patient satisfaction levels regarding the quality of care delivered by private optometry services in South Africa.
Setting: The study was conducted across all nine provinces in South Africa, with a specific focus on individuals utilising private optometry services.
Methods: This study employed a quantitative, cross-sectional design to evaluate patient satisfaction levels regarding service quality in private optometry practices within South Africa, utilising questionnaires disseminated through social media platforms for data collection.
Results: Our study included 283 participants, with a mean age of 36.3 ± 10.41 years, predominantly female (69.8%) and Black African (96%), and found high satisfaction scores with optometrists. The primary reasons for visiting optometrists in our cohort were spectacle
or contact lens renewal (34.9%), routine check-ups (24.5%) and addressing reduced vision (24.5%). Among those who switched optometrists, 40.8% cited relocation and 17.9% reported service dissatisfaction. The mean overall satisfaction score was 4.38 ± 0.66, with high ratings for cleanliness, physical facilities and staff conduct. Conversely, waiting time and cost received relatively lower scores.
Conclusion: Participants were highly satisfied with private optometry services in South Africa, although cost and waiting time had comparatively lower ratings.

Contribution: The study provides evidence on patient satisfaction in private optometry and highlights areas for service improvement.

Sociodemographic outcomes of childhood trauma experiences among young adults in the rural community of South Africa

Bonolo Mmereki — 2026-08-06

Background: Childhood trauma is a moving target, as its negative effects extend beyond the immediate mental health of individuals and continue to affect the victim years after it has occurred.
Aim: The study aimed to determine the sociodemographic determinants of childhood traumatic events among young adults in the rural community.
Setting: The study was conducted in South Africa.
Methods: A quantitative, cross-sectional descriptive survey design was used to gather data among a sample of 380 participants in the rural community of the North West province. Data were collected using four sets of questionnaires to screen demographic determinants,
childhood traumatic events and symptoms of depression and anxiety in the rural community of the North West.
Results: With the probability set at p < 0.20, the findings showed that sociodemographic outcomes associated with childhood traumatic events are level of education, employment status, planning children, residence within the rural community, substance use, religious
beliefs and depressive and anxiety symptoms.
Conclusion: The findings of the study confirm that sociodemographic determinants are important factors in understanding the impact of childhood traumatic events.
Contribution: This insight highlights the need for screening of childhood traumatic events. Depressive and anxiety symptoms should be prioritised in health facilities in South Africa.

Health-related quality of life and demographic profiling of patients with selected noncommunicable diseases

Lynn Smith — 2026-08-06

Background: Health-related quality of life (HRQoL) reflects physical, mental and socioeconomic well-being. In people living with chronic noncommunicable diseases (NCDs), HRQoL is an important indicator of treatment effectiveness and long-term outcomes. Understanding
domain-specific strengths and vulnerabilities can support person-centred care.
Aim: To determine the demographic profile and HRQoL of adults living with hypertension, type 2 diabetes mellitus and/or cardiovascular disease (CVD).
Setting: Public and private healthcare facilities in the Johannesburg metropolitan district, South Africa.
Methods: A quantitative cross-sectional survey was conducted. Using purposive stratified random sampling, 257 adults with hypertension, type 2 diabetes mellitus and/or CVD completed the 37-item Smith Toolkit for Integrated Health-Related Quality of Life. The
instrument assesses physical, mental and socioeconomic domains and demonstrated strong reliability. Data were collected in person and online and analysed descriptively using SPSS version 28.
Results: Overall HRQoL was moderate to high (77.70 ± 12.91). Physical health scores were strong (80.31 ± 15.78), with favourable ratings for symptoms, work functioning and physical limitations, although vitality was lower (52.40 ± 34.01). Mental health scores were moderate
(72.02 ± 17.19), with lower self-efficacy and evidence of psychological challenges. Socioeconomic health was strong (81.49 ± 17.66), supported by high perceived social support, financial stability and relationship quality.
Conclusion: Participants generally reported good HRQoL despite living with chronic NCDs. However, lower vitality and self-efficacy indicate important gaps in psychological and behavioural functioning. Interventions targeting fatigue, resilience and self-management may further improve well-being and health outcomes.
Contribution: This study provides context-specific evidence on HRQoL among South Africans living with NCDs and highlights the value of holistic, interdisciplinary and person-centred care.

A framework to support dental radiography as part of diagnostic radiography practice

Keshini Govindasami — 2026-08-20

Background: The availability of evidence-informed frameworks to support learning interventions in dental radiography for diagnostic radiographers is limited. The framework used in this study was guided by participatory action research and adapted using the precede-proceed model. The framework is underpinned by social justice and systems and learning theory.

Aim: This study aimed to determine and describe the application of a framework for supporting dental radiography as part of diagnostic radiography practice.

Setting: Public and private radiology departments selected higher educational institutions from provinces of KwaZulu-Natal, Gauteng and Western Cape, inclusive of members from the Radiography and Clinical Technology Board at the Health Professions Council of South Africa.

Methods: A sequential mixed-methods design was used for framework development, guided by the Precede-Proceed Model. Stage 1 involved a needs assessment, which comprised a quantitative Phase 1 and a qualitative Phase 2, which included an online questionnaire and semi-structured interviews, respectively. Stage 2 focused on the planning and delivery of the online Continuous Professional Development programme. Stage 3 involved a post-programme quantitative questionnaire to evaluate participant feedback and learning outcomes.

Results: A strength of the framework is professional resilience and adaptability, enabling adaptation to technological advances and the changing needs of patients. The framework proposes a practical way to form targeted continuous professional development (CPD) initiatives, making it valuable in resource-constrained environments.

Conclusion: The framework is beneficial for supporting dental radiography training and practices and promoting equitable access to dental radiography.

Contribution: This framework adds value for supporting the practice of dental radiography for the diagnostic radiographers.

Comparative analysis of COVID-19 vaccine and booster acceptance among healthcare workers in public and private sectors in KwaZulu-Natal, South Africa

Viloshini K. Manickum — 2026-08-20

Background: The coronavirus disease 2019 (COVID-19) pandemic posed unprecedented global health challenges, necessitating accelerated COVID-19 vaccine development. However, vaccine and booster hesitancy among healthcare workers (HCWs) presented a barrier globally and in South Africa (SA).

Aim: This study aimed to determine the level of vaccine and booster acceptance among HCWs in public, private and public-private sectors in KwaZulu-Natal (KZN), SA, and to identify the key reasons of vaccine and booster acceptance and refusal.

Setting: This study was conducted across KZN.

Methods: A quantitative, descriptive, cross-sectional survey was conducted from October 2024 to April 2025 among doctors, nurses and pharmacists using an online questionnaire. Three hundred and thirty-one HCWs participated in this study with a reliable and standardised questionnaire. Data analysis included descriptive and inferential statistics. Relevant ethics committees and participants provided ethical approval.

Results: Average vaccine acceptance rate for vaccine and booster was 92.4 % (n = 306) and 73.7 % (n = 244), respectively. Public-private recorded the highest acceptance rates for vaccine (96.3 %) and booster (85.1 %). Primary reasons for vaccine refusal included vaccine-related illness in family (52.4 %, n = 11) and rapid development and safety concerns (64 %, n = 16), predominantly among private sector. Main booster refusal reasons included safety of multiple booster doses (50 %, n = 32) and antibodies from previous COVID-19 infection, mostly in the public sector.

Conclusion: Addressing complex determinants of vaccine hesitancy across healthcare sectors necessitates an integrated and sustained approach reinforced by multidisciplinary stakeholder engagement. Contribution: This study contributes to future pandemic preparedness and vaccination programmes by elucidating reasons influencing vaccine acceptance and refusal among HCWs.

Contribution: This study contributes to future pandemic preparedness and vaccination programmes by elucidating reasons influencing vaccine acceptance and refusal among HCWs.

Coping mechanisms of bullying survivors: Experiences of secondary school learners at Mamusa sub-district in the North West province, South Africa

Kgalaletso V. Mokeng — 2026-08-20

Background: Bullying in schools has become a public health concern as it continues escalating and causing mental health issues, such as depression. Thus, victims of bullying apply various coping mechanisms for self-defence against bullies.

Aim: This study explores and describes coping mechanisms used by bullied survivors of the specific school.

Setting: Interviews were conducted at the participants’ homes in the Mamusa sub-district in Dr Ruth Segomotsi Mompati district in the North West province, South Africa.

Methods: A qualitative research approach following exploratory, descriptive and contextual designs was used. Twelve participants were selected using purposive sampling. Data were collected through in-depth individual face-to-face unstructured interviews until data saturation. Thematic analysis, following Braun and Clarke’s six-step process, was used to analyse the data. Principles of ethical consideration were adhered to, and trustworthiness was ensured through credibility, dependability, confirmability, transferability and authenticity.

Results: Two themes emerged: positive and negative coping mechanisms with six sub-themes.

Conclusion: The findings revealed that victims used positive and negative coping mechanisms to deal with school bullying, which negatively affected the well-being of victims both academically and socially. Furthermore, extensive awareness and education on bullying needs to be promoted in schools to empower victims and learners. Concurrently, education on school bullying needs to be incorporated into nursing education for the proper management of victims.

Contribution: The new information resulting from this research may improve teaching and nursing education regarding how nurses and teachers should be trained on the prevention of bullying at schools. Extensive awareness and education on anti-bullying policies need to be emphasised in schools to deal with school bullying.

Profiling burnout dimensions and associated sociodemographic variables among medical and health sciences academic staff in a South African university

Charmaine D. Pillay — 2026-08-20

Background: Despite the high academic ratings of South African universities, research on burnout in academia, particularly among health professional academics, is limited. This gap in scholarly knowledge underscores the need for immediate studies in this area.

Aim: The study assesses the burnout dimensions and demographics of health professional academics.

Setting: Faculty of Medicine and Health Sciences, Walter Sisulu University, Eastern Cape, South Africa.

Methods: A quantitative, descriptive, cross-sectional research design was followed. Respondents were recruited via the census (n = 56). The Modified Maslach Burnout Inventory (MMBI) Likert scale questionnaire was used. Statistical Package for the Social Sciences was used to analyse the data: Analysis of variance (ANOVA) was employed to compare mean burnout scores across multiple categorical independent variables. The chisquare test was used for associations between categorical variables. The significance level was set at p < 0.05.

Results: Respondents experienced moderate levels of emotional exhaustion (EE; 46.8 %), low-to-moderate levels of depersonalisation (DP; 40.4 %) and moderate levels of personal accomplishment (PA; 42.6 %). There is no statistically significant difference in burnout dimensions across age groups (p = EE: 0.466, DP: 0.414, PA: 0.467), gender (p = EE: 0.917, DP: 0.593, PA: 0.952), type of degree (p = EE: 0.909, DP: 0.657, PA: 0.939), academic position (p = EE: 0.982, DP: 0.907, PA: 0.430), work experience (p = EE: 0.730, DP: 0.951, PA: 0.905).

Conclusion: The findings suggest that health professional academics are either at risk for burnout or are experiencing moderate levels of burnout.

Contribution: Staff welfare can be improved through strategies to reduce work-related stress, provide mental health support, and promote a healthy work–life balance.

Nurses’ experiences implementing clinical practice guidelines for detecting and managing chronic kidney disease in Eswatini’s primary healthcare facilities: A qualitative study

Delisile F. Simelane — 2026-08-20

Background: Chronic kidney disease (CKD) is an emerging public health concern in Eswatini, with increasing prevalence among individuals with hypertension and diabetes. In primary healthcare facilities, professional nurses are essential to the early detection and management of CKD, guided by clinical practice guidelines and standardised protocols for noncommunicable diseases.

Aim: This study explored the experiences of nurses in implementing clinical practice guidelines for the detection and management of CKD in primary healthcare facilities in Eswatini.

Setting: Nine selected primary healthcare facilities across Eswatini.

Methods: A qualitative, descriptive, and contextual design was used. Semi-structured interviews were conducted with 25 professional nurses, using purposive sampling. Interviews were transcribed, and thematic analysis was conducted following Gibbs’ six-step framework, with ATLAS.ti used to support data management and organisation.

Results: Three key themes and 12 sub-themes emerged from the data analysed. The three themes were: (1) nurses’ experience in implementing clinical practice guidelines, (2) training on the implementation process and the content of clinical practice guidelines, and (3) benefits of clinical practice guideline implementation.

Conclusion: Investing in nurse training in clinical practice and its implementation is essential to improving the detection and management of CKD in Eswatini’s primary healthcare facilities.

Contribution: The study provides valuable insights into the experiences of primary healthcare nurses implementing clinical practice guidelines for the early detection and management of CKD, shedding light on the challenges faced and opportunities to improve implementation in resource-constrained settings.

Perceptions and experiences of nurses on the care of children with malnutrition under 5 years at Intermediate Hospital Katutura, Khomas region, Namibia

Ndamononghenda Malangu — 2026-08-20

Background: Malnutrition in children under 5 years commonly presents as stunting, wasting or micronutrient deficiencies. These conditions lead to high admission rates and nursing burnout at Intermediate Hospital Katutura, Khomas region, Namibia. Despite this impact, a significant knowledge gap exists regarding the perceptions and experiences of Namibian nurses in caring for these children.

Aim: This study explored and described the perceptions and experiences of nurses regarding the care of malnourished children under five in the paediatric ward.

Setting: The study was conducted in the paediatric ward of Intermediate Hospital Katutura, Khomas region, Namibia.

Methods: A qualitative, exploratory, descriptive and phenomenological design was employed. Data were collected from 11 nurses via purposive sampling through individual face-to-face interviews and analysed according to themes. Trustworthiness and ethical principles were rigorously applied.

Results: Five themes emerged: (1) patient and caregiver-related factors; (2) experiences of health facilities or institution-related factors; (3) perceived health provider-related challenges; (4) health provider perceptions of facilitators and recommendations; and (5) perceived legal factors.

Conclusion: Nurses identified significant barriers to care, including a lack of specialised training, negative workplace relationships and systemic socio-economic challenges like poverty and gender-based violence. Issues with health worker relationships and the availability of childcare acts and guidelines were also identified. Therefore, the Ministry of Health and Social Services needs to recruit additional staff and ensure sufficient resources.

Contribution: This study identifies the need for specialised postgraduate paediatric training, providing a framework for the development of malnutrition management guidelines and establishing an evidence base for nurse-led community awareness programs.

Exploring barriers to the expanded programme on immunisation service utilisation in pastoralist communities of Afar, Afar Regional State, Ethiopia

Mohammed A. Bilal — 2026-08-20

Background: Vaccination is a crucial public health intervention for reducing child mortality and morbidity, but Ethiopia and Africa have not met the Global Vaccine Action Plan’s target.

Aim: The study aimed at exploring barriers to the expanded programme on immunisation service utilisation in pastoralist communities of Afar Regional State, Ethiopia.

Setting: The research study was conducted in the Afar region of Ethiopia.

Methods: A qualitative research approach was utilised, combining exploratory and descriptive designs with an appreciative inquiry method. The study focused on parents or guardians of children aged 12 months – 23 months who missed vaccines, along with Expanded Program on Immunisation (EPI) health workers, totalling 77 participants (60 parents and 17 healthcare providers). Data were collected through one-on-one interviews and focus group discussions, with the sample size determined by data saturation, employing non-probability purposive sampling.

Results: Four main themes from the interview data include barriers to community immunization programs, such as geographical challenges, family mobility, vaccine hesitancy due to concerns about side effects, and general reluctance or ignorance regarding vaccination.

Conclusion: The study identified barriers to community immunisation programmes, including geographical challenges, family mobility, vaccine hesitancy due to concerns about side effects and general reluctance or ignorance regarding vaccination.

Contribution: This study provides context-specific insights into nursing care supervision, informing practice and policy for primary health care professionals in patient management and serving as a foundation for future research.

Exploring experiences of faculty of health sciences students on interprofessional collaboration in the healthcare settings in the Khomas region, Namibia

Daniel O. Ashipala — 2026-08-20

Background: Globally, interprofessional collaboration (IPC) has been shown to improve patient outcomes and foster teamwork. While IPC forms an integral part of healthcare delivery, enabling professionals from various disciplines to work together in achieving holistic patient care, in Namibia, there is little research on the experiences of Faculty of Health Sciences students on IPC.

Aim: The aim of this study was to explore and describe the experiences of Faculty of Health Sciences students on IPC in healthcare settings within the Khomas Region, Namibia.

Setting: This study was conducted at the National University in Namibia.

Methods: A qualitative exploratory contextual design was used. Data were collected through individual, in-depth, semi-structured interviews with 16 Faculty of Health Sciences students. All interviews were audio recorded with a digital voice recorder followed by verbatim transcriptions, with the participants’ permission. The collected data were analysed thematically to identify recurring themes.

Results: Three main themes emerged: (1) Understanding IPC as a learning and teamwork opportunity, (2) barriers to ineffective IPC in clinical settings and (3) mechanisms for enhancing IPC in healthcare settings.

Conclusion: This study revealed that IPC is seen as a pathway to better teamwork and improved patient care outcomes among healthcare students. However, addressing challenges such as fostering effective interprofessional relationships is crucial for optimising IPC in healthcare settings.

Contribution: Understanding student’s experiences on IPC can contribute to the development of ongoing strategies and targeted interventions geared towards enhancing strong IPC and promoting teamwork, effective communication and improved patient-centred care.

Factors contributing to the use of traditional herbal medicine among hospitalised high-risk pregnant women in Namibia

Foibe T. Teofilus — 2026-08-20

Background: Traditional herbs are widely used during pregnancy, especially in developing countries, influenced by cultural beliefs and accessibility. Pregnant women often use these remedies to relieve discomfort. Despite ongoing debate about their safety and efficacy, little is known about factors influencing their use, highlighting the need for further research and clearer clinical guidance to ensure maternal and foetal safety.

Aim: The purpose of this study was to explore and describe the factors contributing to the use of traditional herbs among pregnant women at Rundu Intermediate Hospital, Kavango East Region, Namibia.

Setting: The study was conducted in the maternity wards of an intermediate hospital in Namibia.

Methods: A qualitative, explorative, descriptive design was employed. Data were collected through semi-structured interviews guided by open-ended questions. Fifteen pregnant women were purposively sampled based on inclusion criteria.

Results: Four main themes emerged from the data analysis: reasons for using traditional herbs during pregnancy, perceived benefits of traditional herbs, motivating factors influencing the use of traditional herbs and strategies to address the use of traditional herbs.

Conclusion: The study concluded that pregnant women’s widespread use of traditional herbal remedies is motivated by cultural beliefs, perceived health benefits and accessibility. Accordingly, it would appear that pregnant women may have insufficient awareness of potential risks.

Contribution: Findings from this study can be used to implement culturally responsive health education on the risks and consequences of the use of herbal remedies, as well as to strengthen prenatal promotion programmes to ensure safe and integrated maternal care outcomes.

Professional nurses’ knowledge of prevention and management of peritonitis in renal units

Candice C. Williams — 2026-08-20

Background: Peritoneal dialysis–associated peritonitis remains a serious complication contributing to morbidity, mortality, and treatment failure among patients with end-stage kidney disease. Despite evidence-based guidelines, rising infection rates highlight the need to strengthen professional nurses’ knowledge to improve prevention based on evidence-based guidelines.

Aim: To develop, implement and evaluate an educational intervention to enhance professional nurses’ knowledge regarding the prevention and management of peritonitis in renal units in Nelson Mandela Bay.

Setting: Three renal units in private and public hospitals in Nelson Mandela Bay.

Methods: A quantitative, quasi-experimental one-group pre-test and post-test design was employed. A census sample of n = 37 professional nurses was included. Baseline and postintervention knowledge were assessed using a structured questionnaire. An educational intervention aligning with the 2022 International Society for Peritoneal Dialysis peritonitis guidelines was implemented. Data were analysed using descriptive and inferential statistics with the assistance of a statistician. Validity and reliability were assessed, and ethical considerations were upheld.

Results: Post-intervention knowledge scores improved across all domains. Statistically significant improvements were observed in knowledge related to the definition and measurement of peritonitis (p = 0.011), prevention strategies (p = 0.029), and overall knowledge (p = 0.007), with moderate effect sizes.

Conclusion: A guideline-based educational intervention significantly improved professional nurses’ knowledge of key aspects of peritonitis prevention and recognition. Integrating structured, evidence-based education into renal nursing practice may enhance patient outcomes and promote safer peritoneal dialysis care.

Contribution: This study provides evidence supporting targeted educational interventions to strengthen renal nursing practice and improve adherence to international peritoneal dialysis guidelines.

Nursing care supervision: A qualitative study of staff and auxiliary nurses’ experiences in Limpopo province

Munyadziwa R. Raliphaswa — 2026-08-20

Background: According to the South African Nursing Council’s regulation R 2127, staff and auxiliary nurses must be supervised by professional nurses. This supervision is essential for quality care, leading to fewer patient complaints and higher satisfaction.

Aim: This study aimed to explore and describe the experiences of staff nurses and auxiliary nurses on the supervision of nursing care by professional nurses in Limpopo province.

Setting: The study was conducted in three selected regional hospitals located in different districts of Limpopo province: Vhembe, Mopane, and Waterberg.

Methods: A qualitative approach using exploratory, descriptive, and appreciative inquiry research designs was selected to gain insights into professional nurses’ supervision of nursing care. Non-probability purposive sampling was used to choose districts, hospitals, units, and participants. Data were collected through focus group interviews with participants from paediatric, maternity, and casualty units and analysed using Tesch’s eight steps of data analysis.

Results: Four themes emerged: Staff shortages, educational and training challenges, attributes of a good supervisor, and the roles and responsibilities of supervisors.

Conclusion: To improve the quality of patient care outcomes and reduce patient complaints and lawsuits, professional nurses must supervise nursing care. However, the current difficulties jeopardise professional nurses’ ability to optimally supervise nursing care.

Contribution: This study contributes to improving the quality of supervision of nursing care, which is aimed at achieving high patient satisfaction, reducing patient complaints and related medico-legal negligence cases. This study also demonstrates how effective supervision by registered professional nurses can enhance the knowledge and skills of both staff nurses and auxiliary nurses.

Leading through the pandemic: Experiences of diagnostic radiography middle managers during the COVID-19 pandemic

Yolanda Le Roux-Arries — 2026-08-20

Background: Seven years since the onset of the global coronavirus disease 2019 (COVID-19) pandemic, healthcare delivery, particularly within radiology and imaging services, has been reshaped. Amid the surge of COVID-19 infection rates, diagnostic radiography middle managers (DRMMs) were tasked with implementing new protocols, managing increased imaging demands and leading teams through uncharted territory. The exposed gaps in middle management crisis preparedness during the global health emergency highlighted the need for support structures within the imaging sector.

Aim: This article focuses on the experiences of DRMMs during the COVID-19 pandemic and the management strategies they applied in response to the global health emergency.

Setting: The study was conducted at a private radiology practice operating at various imaging branches in the Western Cape and KwaZulu-Natal in South Africa.

Methods: A qualitative study was conducted using a case study design. Eleven DRMMs were recruited through purposive sampling. Semi-structured interviews were conducted and recorded via the Zoom online platform. Manual coding was performed, and the data were analysed using thematic analysis.

Results: Three main themes were identified: adapting to change, challenging environment and managerial growth amid the pandemic. The DRMMs expressed the various operational management challenges they experienced, the uncertainties and doubts they had to navigate and the new skills and abilities they developed.

Conclusion: The study participants experienced feeling out of control and unprepared at the start of the pandemic, but they surmounted the difficulties and grew from the experience. The recommended frameworks are designed to provide support to DRMMs during future global health emergencies.

Contribution: The study demonstrated that better-structured support mechanisms for DRMMs should be in place to safeguard radiology staff members from potential adverse effects.

Senior emergency medical care students’ readiness and confidence to practice paediatric pain management

Suzan-Lynn Smit — 2026-09-07

Background: Paediatric pain is frequently under-managed in prehospital care despite the
known consequences. Practitioner-related factors, during transition from student to
independent practice, influence pain management decisions.
Aim: This study aimed to explore and describe the elements influencing senior undergraduate
emergency medical care students’ self‑reported attitudes, perceived readiness to practise and
confidence in managing paediatric pain in South Africa and to identify self‑reported barriers
and enablers shaping their approach to paediatric pain management.
Setting: The study was conducted among exit-level emergency medical care students at a
South African university.
Methods: A qualitative, descriptive and exploratory design was employed. Using purposive
sampling, semi-structured interviews were conducted with ten final-year Emergency Medical
Care students registered at a South African university within two months of graduation.
Interviews were audio-recorded, transcribed verbatim and analysed inductively using
reflexive thematic analysis.
Results: The authors generated two themes. Theme one: Attitudinal dissonance, reflected a
disconnect between beliefs about paediatric pain management and confidence in practice.
Scepticism towards pain expression, fear of harm and protocol reliance contributed to practice
hesitancy. Theme two: Fear and uncertainty, highlighted perceived educational gaps and
limited clinical exposure, which reduced participants’ perceived practice readiness.
Conclusion: Emergency medical care students’ self-reported paediatric pain management is
shaped by the interaction of attitudes, emotional responses and educational structures within
prehospital training.
Contribution: The study provides South African prehospital education-specific insight into
factors influencing paediatric pain management and supports the need for curriculum
refinement and enhanced learning and teaching methods to improve student preparedness
and patient care.

The lived experiences of South African parents during high-risk pregnancy and prolonged neonatal intensive care unit admission

Linda H. Goldberg — 2026-09-07

Background: Becoming a parent is a significant life event; however, premature birth abruptly alters this transition, creating short- and long-term consequences for both parents and infants.
Aim: This study sought to explore the lived experiences of South African parents throughout the trajectory of premature birth and the subsequent hospitalisation of their baby in the neonatal intensive care unit (NICU).
Setting: The research was conducted in Johannesburg, South Africa, within the private healthcare setting.
Methods: A quantitative, exploratory and descriptive phenomenological study design was used. Purposive sampling identified participants, and 11 interviews were conducted with eight mothers and three fathers. Inductive thematic analysis using MAXQDA identified emerging codes, categories and themes.
Results: Three themes emerged: the journey to the NICU and the pregnancy context, transitioning to parenthood within the unnatural NICU environment, and the emotional journey during the prolonged admission. Parents reported limited psychosocial support from
doctors, nurses and other parents.
Conclusion: The challenges experienced by the parents mirrored common themes identified in global research. Parents described the psychosocial challenges during the pregnancy and neonatal admission, and the difficulties of achieving the parental role within the NICU
environment. Confounding this was the limited exposure to formal psychosocial counselling by trained professionals.
Contribution: This research highlights the psychosocial challenges experienced by parents during the admission period in private-sector NICUs and the need for increased, planned and structured psychosocial support.

Patients’ satisfaction in positron emission tomography/ computed tomography departments in Gauteng province, South Africa

Themba Tshabalala — 2026-09-07

Background: Patient satisfaction is a subjective metric, yet an important one used for evaluating healthcare performance and identifying areas for improvement. Since the introduction of positron emission tomography/computed tomography (PET/CT) in South Africa in 2005, limited information is available on patient satisfaction in PET/CT departments. Understanding patients’ experiences in this setting is essential to ensure the delivery of high-quality, patient-centred care.

Aim: This study assessed patients’ satisfaction with care when undergoing PET/CT examinations.
Setting: The study was conducted at three selected academic public hospitals in the Gauteng province of South Africa.
Methods: This study employed a quantitative, cross-sectional, descriptive research design to collect data from 226 randomly selected respondents between March 2022 and September 2022. A structured, closed-ended, adapted questionnaire utilising a 5-point Likert scale was used to collect data through telephone surveys.
Results: This study had a predominance of female respondents (62.4%) over male respondents (37.6%). Overall, the study reported high satisfaction levels regarding staff’s professionalism (92.5%), the privacy provided in the examination rooms (94.2%), the cleanliness of the examination rooms (88.9%), reception areas (90.3%), and toilets (93.8%), while only 0.4% expressed no satisfaction at all because their appointments were not kept at the scheduled times.
Conclusion: This study suggests that the majority of patients were satisfied with the level of service and care they received during PET/CT examinations. However, there is a need to improve patient appointment adherence for achieving better clinical outcomes.
Contribution: Positron emission tomography/computed tomography staff should advise patients with appointment choices and provide service at the scheduled times.

The correlation between depression and haemodialysis adequacy in chronic kidney disease patients in South Africa

Bongani V. Miya — 2026-09-07

Background: Chronic kidney disease (CKD) is a global health concern projected to be the fifth most prevalent chronic disease by 2040, associated with high mortality and significant psychosocial burdens.
Aim: This study aimed to explore and describe the correlation between depression and haemodialysis adequacy in CKD patients.
Setting: Research was conducted across five units in the Free State and Northern Cape provinces, South Africa.
Methods: This quantitative, cross-sectional, prospective analytic study included 78 patients selected via convenience sampling, and trustworthiness and ethical principles were adhered to throughout the study. A biostatistician analysed the raw data using the statistical analysis system (SAS). Data collected over 3 months involved objective measurements of online dialysis adequacy (Kt/V) and pathology (creatinine, urea), alongside subjective depression assessments using the Beck Depression Inventory (BDI).
Results: The median BDI score was 17 (Interquartile range [IQR]: 13–22), reflecting mild-to-severe depressive symptoms. The median online Kt/V was 1.04. A significant inverse association was found between BDI scores and Kt/V (p = 0.0231), indicating that higher
depressive symptoms correlate with lower adequacy. No significant relationships were observed between depression and creatinine or urea levels.
Conclusion: Lower dialysis adequacy is significantly associated with increased depressive symptoms. Findings highlight the urgent need to integrate mental health screening and psychosocial support into routine renal care to improve patient outcomes.
Contribution: The findings highlight the necessity of psychosocial support, patient compliance, and education to improve employment and nutritional security, and advocate for comprehensive medical insurance coverage.

Uptake of antiretroviral therapy among people living with HIV in Addis Ababa, Ethiopia: A qualitative exploratory study

Ayehu M. Belay — 2026-10-07

Background: Unsuppressed viral load despite antiretroviral therapy (ART) remains a major challenge to effective HIV treatment in Ethiopia. In Addis Ababa, retention in care and adherence remain problematic despite the widespread implementation of differentiated service delivery (DSD) models.
Aim: To explore ART uptake among people living with HIV (PLHIV) in Addis Ababa from the perspectives of PLHIV and healthcare providers, using a qualitative exploratory approach.
Setting: The study was conducted in eight selected public health centres in Addis Ababa, Ethiopia.
Methods: A qualitative exploratory study design was employed, involving in‑depth interviews with a purposive sample of 36 participants: 20 people living with HIV and 12 healthcare providers (including ART nurses, pharmacists and HIV programme coordinators). Data were analysed thematically to investigate key barriers and facilitators influencing ART uptake.
Results: Six themes emerged: (1) structural and systemic barriers, including drug shortages and transportation challenges; (2) psychosocial‑related barriers, such as stigma and fear of disclosure; (3) variable awareness and perceptions of DSD models; (4) adherence motivators, including health preservation and social support; (5) provider–patient relationship dynamics; and (6) recommendations focusing on health‑system reforms and community engagement. Limited awareness of DSD options and inconsistent implementation reduced the effectiveness of DSD models.
Conclusion: Improving ART delivery in Addis Ababa requires integrated interventions that address structural, economic and psychosocial barriers, strengthen patient–provider communication and enhance community engagement.
Contribution: The study provides actionable, context‑specific evidence on barriers and facilitators to ART uptake, supporting efforts to improve adherence and retention and to advance progress towards global HIV targets and Sustainable Development Goals 3.3 and 3.8.

A longitudinal quantitative study of the effects of training on food handlers’ hygiene knowledge and practices in the National School Nutrition Programme, Western Cape, South Africa

Hayley K. Langley — 2026-10-07

Background: The National School Nutrition Programme (NSNP) provides food to approximately 9.7 million learners across South Africa. Children are more vulnerable to foodborne disease, especially if food is prepared unhygienically. Although foodborne disease outbreaks occur in South African schools, few studies have examined the knowledge and
practices of food handlers in the NSNP.
Aim: The aim of the study was to determine whether food hygiene knowledge training intervention at schools offering the NSNP will improve food handlers’ knowledge and practices regarding food hygiene and safety.
Setting: The study was conducted at 10 schools within a Cape Winelands sub-district municipality offering the NSNP.
Methods: A quantitative longitudinal design was employed, utilising a pre-test–post-test intervention study. Data were collected using structured questionnaires to assess knowledge, and an observation checklist was used to assess the practices of the food handlers before and after training.
Results: Pre-training findings showed that most food handlers have a high baseline food hygiene knowledge, yet observations found poor compliance with required practices. After the training intervention, no statistically significant differences (p < 0.05) were found between pre- and post-training questionnaire results. However, post-training observations found clear improvement in hygiene practices.
Conclusion: Despite improvement, the study revealed that a lack of resources is the main challenge in implementing safe food handling practices in the NSNP.

Contribution: This study underscores the need to strengthen compliance and routine inspections and prioritise food safety within the NSNP. Future studies should explore behavioural and attitude factors that influence these food handlers.

Risk factors of hypertension in South Africa: A systematic review and meta-analysis to inform the development of a clinical prediction model

Martins Nweke — 2026-10-07

Background: Hypertension is a major cause of preventable cardiovascular morbidity and mortality and remains a significant public health challenge in South Africa. Most existing risk prediction models were derived from high-income populations and may not perform well in low- and middle-income settings.
Aim: To synthesise pooled evidence on risk factors of hypertension in South Africa and use the findings to inform the development of a clinical prediction model.
Setting: South Africa.
Methods: A systematic review and meta-analysis were conducted using studies retrieved from PubMed, Scopus, Academic Search Complete, MEDLINE, Web of Science and African Journals (SABINET) from 1990 to March 2025. Titles, abstracts and full texts were screened independently by two reviewers. Random-effects meta-analysis was used to pool odds ratios for eligible risk factors. Certainty of evidence was assessed using Grading of Recommendations Assessment,
Development and Evaluation (GRADE), while predictor selection for model development was guided by risk weight and geotemporal trend.
Results: Fifty-four studies, including cross-sectional, case–control and cohort designs, were included. The studies covered multiple South African provinces, with 15 national studies spanning all nine provinces. Strong pooled associations were observed for dyslipidaemia (odds ratio [OR] 3.79, 95% confidence interval [CI] 1.84–7.80), age > 50 years (OR 3.49, 95% CI 1.82–6.70), diabetes (OR 2.57, 95% CI 1.86–3.53), obesity (OR 2.35, 95% CI 1.89–2.91) and gold mine dust exposure (OR 2.35, 95% CI 1.70–3.25). These findings informed the final prediction model.
Conclusion: Age, metabolic factors, environmental exposures and selected social determinants were important predictors of hypertension. The resulting model may support early screening in primary care, although external validation is required.
Contribution: This study synthesises South African evidence on hypertension risk factors and translates the findings into a context-specific clinical prediction model.

Perspectives on substance abuse among nursing students and educators in Eastern Cape, South Africa

Nomthandazo M. Sululu — 2026-10-07

Background: Substance abuse in nursing raises ethical and legal concerns, with 10% – 20% of students affected. Research indicates these behaviours often continue into professional practice and need to be addressed.
Aim: To explore and describe the perceptions of nurse educators and student nurses regarding substance abuse and to make recommendations to address substance abuse at a public nursing college in the Eastern Cape.
Setting: A public nursing college education institution, comprising five main campuses and 18 sub-campuses in the Eastern Cape.
Methods: A qualitative, exploratory and descriptive design was used. Purposive sampling was used to select participants, and data were collected through three nurse educator focus groups and three student nurse focus groups. Nurse educator focus groups consisted of four participants each, and student focus groups consisted of six participants each. The data were analysed using thematic analysis. Trustworthiness was established using Guba and Lincoln’s criteria.
Results: Three themes emerged: (1) Nurse educators and nursing students perceive substance abuse as a complex issue influenced by diverse personal and environmental factors, (2) Substance abuse impacts student nurses across three domains of their well-being and (3) The management of substance abuse within the education institution lacks comprehensive, structured and consistent strategies.
Conclusion: Substance use among nursing students is fundamentally a health and well-being issue that requires professional and structured interventions.
Contribution: Describing the perceptions of nurse educators and nursing students led to a set of recommendations to address substance abuse among student nurses.

Experiences of emergency care practitioners on pre-hospital rapid sequence intubation in South Africa

Tebatso J. Mathobela — 2026-10-07

Background: Pre-hospital Rapid Sequence Intubation (RSI) is a complex, high-stakes and time-sensitive procedure performed in unpredictable resource-constrained environments. Successful execution of pre-hospital RSI demands coordinated teamwork, thorough preparation and clear communication.
Aim: This qualitative study explored the experiences of Emergency Care Practitioners (ECPs) during pre-hospital RSI.
Setting: The study was conducted across three South African provinces: Gauteng, KwaZuluNatal and the Western Cape.
Methods: The study adopted a descriptive qualitative design, using focus group discussions (FGDs) to understand ECPs’ experiences during prehospital RSI. Six FGDs were conducted online via Microsoft Teams. All discussions were audio-recorded, transcribed and analysed using qualitative data analysis software, NVivo 13 (2020 R1).
Results: A total of 39 ECPs voluntarily participated in six FGDs, representing both public and private sectors. The following themes emerged; system-driven administrative demands and procedural complexity, resource and workforce constraints affecting RSI performance and communication-related challenges and information gaps affecting clinical decision-making.
Conclusion: The ECPs voice concerns about challenges that require Emergency Medical Services (EMS) management to implement supportive measures, including improved access to resources and equipment during pre-hospital RSI. Additionally, they argue that practitioner proficiency promotes the effective execution of pre-hospital RSI.
Contribution: The findings of this study and the insights gained can guide EMS leadership and policymakers in formulating targeted strategies that will ensure the availability of essential resources and strengthen operational support to enhance the safety and quality of care delivered to critically ill or injured patients requiring RSI.

Barriers and enablers of work–life balance among regulatory affairs pharmacists working remotely in Gauteng, South Africa: A qualitative study

Kgabo M. Sekgalakane — 2026-11-06

Background: Regulatory Affairs (RA) pharmacists in South Africa transitioned to remote work during the COVID-19 pandemic and continued post-restrictions. Limited research on their work–life balance (WLB) experiences hinders supportive workplace policy development and understanding of work–family conflict dynamics to inform sustainable remote work practices.
Aim: This study aimed to explore the WLB experiences of RA pharmacists following the easing of COVID-19 restrictions.
Setting: The study was conducted in Gauteng province, South Africa.
Methods: An exploratory qualitative design used semi-structured interviews guided by Bronfenbrenner’s framework and the Work–Life Harmony model. Data from 17 participants were analysed thematically using inductive and deductive approaches.
Results: The WLB barriers and enablers emerged across socio-ecological levels. The microsystem included boundary challenges, overwork, isolation and adaptive routines. The mesosystem reflected family support, work–life enrichment and competing demands.
Exosystem factors, including micromanagement, inconsistent policy implementation and limited resources, undermined flexibility and autonomy, while supportive management and peer collaboration enhanced WLB. Macrosystem regulatory demands, time-zone pressures and an output-driven culture extended working hours. The chronosystem reflected evolving work arrangements and boundary-setting.
Conclusion: Remote and hybrid work increased flexibility, family engagement and reduced commuting for RA pharmacists. However, blurred boundaries, overtime, constant availability, micromanagement, inconsistent policies, staffing shortages and poor support undermined autonomy and mental health.
Contribution: The study provides unique insights into WLB barriers and enablers among RA pharmacists, informing management strategies and psychological support for remote work optimisation.

Exploring physiotherapy students’ clinical experiences during educational disruption, through a community of practice lens

Tammy-Lee Williams — 2026-11-06

Background: The COVID-19 pandemic profoundly disrupted health professions education, affecting final-year physiotherapy students at a pivotal stage in their transition to clinical practice.
Aim: This study explores final-year physiotherapy students’ experiences amid heightened uncertainty.
Setting: A historically disadvantaged university in South Africa.
Methods: Guided by Wenger’s Communities of Practice (CoP) framework, this qualitative exploratory study examined how students navigated readiness, fear, support systems and perceived learning gaps. Semi-structured interviews were conducted with nine purposively selected final-year students and analysed thematically.
Results: Participants (seven females, two males; mean age 22.6 ± 1.3 years) reported shared concerns regarding infection risk, the influence of personal protective equipment on clinical performance, degree completion, family safety and the impact of online learning on skill acquisition. However, support from the physiotherapy department reinforced their sense of belonging. Students identified shared resources, including WhatsApp groups, peer support, clinician mentorship and faculty access, as critical to reinforcing their practice.
Conclusion: While shared pandemic-related concerns heavily influenced students’ readiness for clinical learning, their sense of belonging was reinforced by departmental support. Utilising a shared repertoire of communication and mentorship helped them successfully navigate these unprecedented challenges.
Contribution: These findings highlight the importance of creating a supportive and adaptable learning environment during periods of disruption, which centres on clear communication and robust support mechanisms.

Bridging the gap: Investigating somatologists’ knowledge of regulatory bodies in the Free State province of South Africa

Adri Claassen — 2026-11-06

Background: Somatology practice in South Africa continues to expand through advanced aesthetic modalities; however, the profession remains without statutory regulation. Fragmented governance structures create risks regarding client safety, professional accountability and ethical practice. Understanding somatologists’ regulatory knowledge is important for future governance and regulatory progression.
Aim: To investigate somatologists’ knowledge and understanding of regulatory entities relevant to the profession in the Free State province.
Setting: The study included practising somatologists and salon owners in the Free State province of South Africa.
Methods: A quantitative, descriptive cross-sectional design was used. Data were collected through a structured questionnaire distributed by two industry suppliers via WhatsApp and administered through QuestionPro. A total of 143 responses were included. Descriptive statistics assessed familiarity with relevant regulatory entities.
Results: Respondents demonstrated strong recognition of voluntary entities such as the South African Association of Health and Skincare Professionals, but limited awareness of statutory councils. Considerable uncertainty existed regarding regulatory functions, registration requirements and organisational mandates. Knowledge of continuing professional development requirements was limited despite its high perceived value.
Conclusion: The findings support future educational interventions, professional communication strategies and policy discussions regarding statutory regulation.
Contribution: This study provides evidence on regulatory knowledge within an unregulated profession,

Knowledge, attitudes and practices of health professionals regarding nutrition support in public hospitals of Ehlanzeni district, Mpumalanga

Phindile P. Khoza — 2026-11-06

Background: Effective nutrition support improves outcomes and quality of life in malnourished patients, yet hospital practices remain inconsistent.
Aim: This study determined and described health professionals’ knowledge, attitudes and practices regarding nutrition support in public hospitals.
Setting: The study was conducted in 13 public hospitals (10 district, 2 regional and 1 provincial) in Ehlanzeni district, Mpumalanga.
Methods: A quantitative, descriptive, cross-sectional study was conducted among 357 randomly selected health professionals using a self-administered questionnaire. Data were analysed with descriptive statistics and binary logistic regression (Stata 13.0).
Results: Only 38% knew that severe malabsorption and undernutrition with poor oral intake indicate parenteral nutrition. Few participants (7.0% strongly agreed, 11.4% agreed) felt that only dietitians are responsible for nutritional care. Although 74% reported that malnutrition was a hospital priority, only 47% screened patients for malnutrition. Education was the most consistent predictor of knowledge, attitudes and practices (p < 0.05).
Conclusion: Health professionals had moderate knowledge and positive attitudes, but their practices did not align with this knowledge. Structured training, ongoing mentorship and standardised protocols are recommended to support consistent, evidence-based nutrition care using a multidisciplinary, team-based approach.
Contribution: This study adds to the scarce South African data on hospital-based nutrition support by providing district-level findings from Mpumalanga and highlighting the multidisciplinary nature of nutrition support in public health.

A call for action: Guidelines for implementation of mental health services at the community level

Khalaeng F. Thobane — 2026-11-06

Background: Mental health challenges account for approximately 18% of global disease burden. Few people with mental health challenges receive the required treatment, especially at community level. Implementation of mental health services at the community level is vital.
Aim: The study aimed to explore and describe the content for inclusion in the guidelines for the implementation of mental health services in the Ward-Based Primary Health Care Outreach Teams (WBPHCOTs) services in South Africa.
Setting: Data was collected in subdistrict one offices from the experts in mental health services and WBPHCOTs working in Tshwane District, Gauteng province, South Africa.
Methods: A qualitative, explorative and descriptive design that followed a Nominal Group Technique (NGT) for data collection. Eleven experts were purposively sampled for participation in the study. The NGT process was followed: silent generation of ideas, round robin, group discussion and clarification process. Finally, ranking of ideas and group consensus was reached.
Results: The following content was identified for inclusion in the guidelines: visits to households, collaboration with mental health key stakeholders, training, mental health prevention and promotion, adherence to treatment and advocacy, mental health professionals’ support, and strengthening community mental health services.
Conclusion: The study assisted in identifying the content to be included in the guidelines for the implementation of mental health services in the WBPHCOTs’ services.
Contribution: This study provides the content that could be included in the development of the guidelines for the implementation of mental health services in the WBPHCOTs services, with the anticipated contribution to the improvement in the implementation of mental health services at community level.

Exploring needs, preferences and cultural influences on HIV/AIDS self-management among women of reproductive age in Northern Ghana

Alhassan B. Adam — 2026-11-06

Background: Women in sub-Saharan Africa experience a disproportionate burden of HIV/AIDS. Self-management of HIV is influenced by sociocultural and economic factors that shape adherence and well-being.
Aim: To explore and describe the perception of women regarding their needs, preferences and cultural practices influencing self-management of HIV/AIDS in Northern Ghana.
Setting: Antiretroviral therapy (ART) clinics in three main hospitals in Northern Ghana: Tamale Teaching Hospital, Northern Regional Hospital and Tamale West Hospital.
Methods: A qualitative, exploratory and descriptive design was utilised for this study. Twenty women were purposively recruited. Data were collected using semi-structured in-depth interviews. Thematic analysis, guided by Braun and Clarke’s six-step framework was conducted with NVivo 15.2 to organise codes and themes.
Results: Analysis within the perception, enablers, and nurturers (PEN-3) model identified: (1) perceptions of needs for self-anagement: knowledge of HIV disease process, consistent access to ART, well-organised clinic services and preference for long-acting injectables to
reduce pill fatigue; (2) enablers: credible communication channels (mosques, churches, community durbars, festivals, local language media) and moderated digital supports such as WhatsApp reminders and clinic micro-lessons; (3) nurturers: comprised partners, family members, trained peers and digital peer networks that provided reminders and encouragement.
Conclusion: Self-management of HIV/AIDS among women in Northern Ghana extends beyond medication adherence to include psychosocial and cultural dimensions.
Contribution: Identifying women’s needs and preferences for HIV/AIDS self-management, and how religion, sociocultural and contextual factors uniquely shape their ability to manage their condition, providing evidence for culturally relevant, women-centred education programmes.

Technology-enhanced interprofessional simulation in higher education healthcare training

Richard M. Rasesemola — 2026-11-06

Background: Interprofessional education (IPE) prepares students from different health professions to work together in complex healthcare systems worldwide. Although widely valued, integrating IPE into discipline‑bound health sciences curricula remains difficult, with barriers limiting meaningful interprofessional learning experience. Simulation-based education (SBE) addresses some challenges by providing risk‑free environments to practice collaborative clinical skills and decision-making. However, gaps remain in adopting simulation‑based IPE in higher education institutions.
Aim: This study explored the experiences of management and lecturers adopting technology‑enhanced interprofessional simulation (TEIPS) within the Faculty of Health Sciences (FHS).
Setting: This study was conducted in the FHS of a higher education institution based in Johannesburg, South Africa.
Methods: A qualitative, descriptive, exploratory and contextual design was used. Semistructured interviews were conducted with purposively sampled FHS management and lecturers involved in SBE. Data were transcribed and analysed using the Matrix Building Framework approach.
Results: TEIPS helps bridge limitations in traditional IPE by enabling personalised feedback, supporting measurable teamwork behaviours and creating environments where purposeful interdependence is essential for learning.
Conclusion: TEIPS functions most effectively in a curriculum‑embedded ecosystem supported by strong institutional leadership, sustained resources and structured faculty development initiatives.
Contribution: This study addresses critical gaps in educator capacity building and the lack of practice-informed approaches to integrating digital innovations into IPE. It shows how purposeful interdependence, sustained faculty development and curriculum integration enable TEIPS as a measurable, sustainable and equity‑enhancing IPE approach in diverse contexts in varied contexts.

The prevalence of type 2 diabetes mellitus risk factors among patients at three selected clinics in Windhoek, Namibia

Lynnete C. Mukonka — 2026-11-06

Background: Worldwide, there is an increase in the prevalence of type 2 diabetes mellitus (T2DM). Identification of the most prevalent risk factors within different communities assists in taking measures to curb the projected rise in the prevalence of T2DM in the years to come.
Aim: The aim of the study was to determine the prevalence of T2DM risk factors among patients at selected clinics in Windhoek, Namibia, in order to design data-driven preventive strategies.
Setting: The study was conducted at three clinics in Windhoek, Namibia.
Methods: This article uses data taken from a mixed-methods study aimed at developing a lifestyle modification programme for the prevention of T2DM, involving 673 participants. Out of these 673 participants, data from 634 non-diabetic respondents were used. A questionnaire was used to collect data, and the American Diabetes Association (ADA) Diabetes risk test was also used to assess the risk levels among the non-diabetic participants. Descriptive statistics were used to analyse the data.
Results: The most prevalent factor was having a family history of hypertension (258; 42.3%), then history of T2DM (267; 39.7%) and age (223; 33.1%). Other factors identified were random blood glucose levels and waist circumference. Most of the respondents (481; 75.9%) had an overall low risk of developing T2DM, while 98 (15.5%) respondents had a high risk of developing T2DM.
Conclusion: Although the most prevalent factors were non-modifiable factors, the results of the ADA risk test indicate a combination of both modifiable and non-modifiable risk factors. There is a need for preventive strategies, and further research on cost-effective measures is also recommended.
Contribution: The study shows the need for T2DM preventive measures and further research.

Mental health promotion knowledge and practices of nursing students: A qualitative study

Regomoditswe C. Legwabe — 2026-11-06

Background: High levels of mental distress have been documented among nursing students, but only a few seek help to promote or manage their mental health. Although health promotion is included in their curricula and institutional mental health services are provided to support them in managing the stress they experience during their training, it appears as if the students do not practice mental health promotion for themselves.
Aim: The study aimed to explore and describe nursing students’ personal knowledge and the systemic barriers to mental health promotion.
Setting: The research was done at a nursing education institution in the Gauteng Province of South Africa.
Methods: An exploratory, descriptive contextual qualitative study was conducted with eleven undergraduate students during the 2024–2025 academic year. Data were collected through individual, semi-structured face-to-face interviews until saturation was reached, followed by a thematic analysis.
Results: Three categories were identified, namely ‘rely on self, family and friends,’ ‘depend on lecturers and institutional support services’ and ‘the need for mental health promotion for students’.
Conclusion: Nursing students at the institution were partially knowledgeable about mental health promotion but not all practised appropriate health-promoting mechanisms when dealing with academic and personal challenges.
Contribution: Nursing students need to be supported in their academic journey to become professional nurses. The authors recommend that institutions should adopt mental healthsupportive campus cultures to improve students’ mental health, encourage the maintenance of peer support groups and initiate extracurricular health-promoting activities.

Medical practitioners’ perceptions of adverse event reporting for rare diseases in South Africa

Leith F. Kwaan — 2026-11-06

Background: Adverse events (AEs) are underreported. In rare diseases (RDs), this is compounded by small patient populations, complex pathology and limited treatments. Most related research is from developed countries using survey methods.
Aim: This qualitative study aimed to expand on existing knowledge by exploring perceptions of medical practitioners (MPs) managing RDs regarding AE reporting.
Setting: The study took place in the South African public and private healthcare sectors.
Methods: A qualitative, exploratory and interpretive design was employed. Individual interviews were conducted with 12 purposively sampled MPs, exploring their perceptions and experiences of AE reporting, and relevant barriers and facilitators. Transcripts were analysed using reflexive thematic analysis.
Results: Three themes were generated: (1) Trust in healthcare systems, colleagues and doctor–patient interaction impacted reporting. (2) Reporting AEs for medicines with delayed local launch was perceived to contribute insignificantly to safety profiles. Participants’ stewardship of limited treatment options caused reluctance to report AEs and caution around direct patient reporting. (3) Risk tolerance for treatment gain, including off-label use, was perceived to be balanced by medicine safety knowledge.
Conclusion: Pharmacists were trusted for AE reporting. Medical practitioners’ reluctance to report AEs associated with singular treatment options was grounded in concern regarding treatment access. Caution around direct patient reporting was driven by a reluctance to jeopardise treatment access as a result of potentially irrelevant patient-reported events. Risks associated with medicines are mitigated by knowledge generated through AE reporting.
Contribution: Issues surrounding trust relationships, resources and practice risk were identified as underlying AE underreporting by MPs. Proposed solutions included pharmacist involvement and improved medicine supply.

Oral health knowledge, attitude and practices among student nurses at a university in South Africa

Pelisa Khonco — 2026-11-08

Background: Poor oral health resulting from poor knowledge, negative attitudes and poor practices contributes to oral diseases. Oral diseases remain a public health concern and negatively affect student nurses’ academic performance. These students should serve as role models in promoting oral health among communities. A lack of oral self-care among student nurses may raise a health concern.
Aim: To assess student nurses’ knowledge, determine their attitude and practices regarding oral health at a Western Cape university.
Setting: This study was conducted at a Western Cape university, South Africa, which offers undergraduate nursing programmes.
Methods: A quantitative approach with a descriptive design was conducted, and data were collected from a quota sample of 287 student nurses using a self-administered questionnaire. Data captured into IBM Statistical Package for the Social Sciences computer program IBM SPSS Statistics version 28.0 (IBM Corp., Armonk, NY, United States), were analysed using descriptive statistics and Chi-square tests to test associations.
Results: The response rate was 97.9% (281/287). Most of the respondents did not recognise the importance of brushing twice daily and flossing once, and only 98 (34.9%) were knowledgeable. A positive attitude was noted among the majority of the respondents (261, 92.9%) who agreed that oral health knowledge can contribute to the prevention of tooth loss. Good practices were noted among most of the respondents (277, 98.6%) who cleaned their teeth daily with a toothbrush.
Conclusion: Student nurses had poor oral health knowledge, mixed attitudes and fair oral health practices. This study highlights the need for the formal integration of oral health into the nursing curriculum.
Contribution: This study contributed to the body of knowledge in nursing research and education.

Burden of diseases and disease trends in the rehabilitation public health facilities in Gauteng Province, South Africa

Sonti Pilusa — 2026-11-08

Background: Rehabilitation remains an unmet need and a neglected health service in South Africa. To address the country’s complex burden of disease, a skilled rehabilitation workforce is needed.
Aim: This study aimed to identify prevalent medical conditions and disease trends among patients treated by rehabilitation therapists over a six-year period. It further examined whether these prevalent health conditions are represented in the rehabilitation health education curricula.
Setting: The study was undertaken in public healthcare facilities within Gauteng province, South Africa.
Methods: Secondary data on provincial rehabilitation data from April 2019 to March 2024 were analysed and categorised into non-communicable diseases (NCDs), children-specific conditions, injuries, and communicable diseases. Data were analysed descriptively. Lastly, the undergraduate rehabilitation health training curriculum (Occupational therapy, Physiotherapy, Speech therapy and Audiology) was reviewed to assess whether it covers the medical conditions treated by rehabilitation therapists.
Results: The most treated conditions were NCDs (44.1%), injuries (36.4%) and children-specific conditions (15.6%). All health conditions decreased during the coronavirus disease 2019 pandemic, followed by an increase in NCDs and injuries between 2022 and 2024. The undergraduate rehabilitation health training curriculum covers the most prevalent conditions treated by public sector rehabilitation therapists.
Conclusion: The burden of diseases treated in public healthcare rehabilitation departments aligns with the national burden of diseases. The impact of the COVID-19 pandemic on rehabilitation services is evident in the trend analysis over the years. Continual review of the curriculum is needed to ensure local health responsiveness.
Contribution: This study highlights the burden of disease treated by the public health sector rehabilitation therapists, the trends over time and the importance of ensuring that the curriculum is locally responsive.

Navigating care: The burden on caregivers of children with hydrocephalus in South Africa’s teaching hospitals

Makwena M. Sibuyi — 2026-11-08

Background: Caregivers of children with hydrocephalus in low-resource settings face profound challenges, yet their experiences within the South African context are poorly documented.
Aim: This study aimed to investigate the interrelated challenges encountered by caregivers of paediatric patients with hydrocephalus.
Setting: This study was conducted at two academic tertiary hospitals in Limpopo and Gauteng provinces.
Methods: A qualitative exploratory study using semi-structured interviews recruited 39 caregivers of paediatric patients with hydrocephalus. Data were analysed using inductive thematic analysis in NVivo 16 software, and the analysis was halted at saturation.
Results: Caregivers were predominantly young and unemployed. Four overarching thematic challenges emerged: (1) health system challenges; (2) socioeconomic consequences of caring for a child with hydrocephalus; (3) psychosocial and caregiving burden; and (4) formal social protection availability.
Conclusion: Caregivers endure severe, interconnected systemic, financial, and psychosocial burdens that critically compromise their well-being and care capacity. Findings underscore an urgent need for holistic, family-centred interventions, including systemic healthcare reforms, economic protection, integrated psychosocial support, and structured caregiver education programmes to mitigate this crisis and improve patient outcomes.
Contribution: The study advances the understanding of how health system limitations intersect with poverty, amplifying caregiver vulnerability and inequity.