Browsing by Author "Bagwandeen, Chauntelle Ingrid."

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The effectiveness of the induction and orientation programme in the Nkangala Health District of Mpumalanga Province, 2006 to 2007.
(2010) Kunene, Makazi Pearl.; Bagwandeen, Chauntelle Ingrid.; Kistnasamy, Malcolm Barry.
INTRODUCTION The high staff turnover and high rates of absenteeism in health professionals poses an alarming challenge in the Public Health Facilities in the Nkangala Health District of Mpumalanga province. This could lead to the quality of care to patients being compromised. The Human Resource Directorate within the Department of Health has introduced a formal induction and orientation process in the health facilities for new staff which should assist with the retention of staff and enhance their productivity. PURPOSE OF THE STUDY The purpose of this research study was to evaluate the effectiveness of the Human Resource Management unit in implementing the induction and orientation programme for newly appointed health professionals at the Nkangala Health District of Mpumalanga Province. METHODS The study method is quantitative in nature using an observational descriptive design with the minor qualitative component for detailing the quantitative findings. Stratified random sampling was used to select the respondents from the Persal database of 2006-2007. Two hundred and three respondents participated in this study. The Persal database is the human resource database used for managing the personnel records of all permanent employees. A self-administered questionnaire was developed to collect data from the health care professionals at the Thembisile and JS Moroka health facilities in the Nkangala Health District in Mpumalanga. The exposure variable was the implementation of the induction and orientation programme. The outcome variable was the measurement of the effective implementation of the induction and orientation programme. The questionnaire consisted of open- and closed-ended questions covering demographic data and organisational characteristics related to the objectives of the study. The validation of the questionnaire was done in consultation with the Human Resource Development unit of the Nkangala Health District through a pilot study. The data was collected using Microsoft Excel and analysed using SPSS statistical software. RESULTS The data was categorised and interpreted according to the respondents’ views. The findings were presented using categorical variables of medical doctors, allied health professionals, nursing staff and health facility managers. The site questionnaire was based on the Departmental Transformation Unit tool to assess the 6 variables being purpose, empowerment, relationships and communications, flexibility, optimal productivity, recognition and morale relating to the performance of health facilities. MS Excel was used to consolidate the views of the respondents in relation to the implementation of induction and orientation programme which did not benefit the medical doctors and allied health professionals as they were not assigned with mentors. DISCUSSION This study identified the most important interventions and support that newly employed health professionals expected in their career development. The induction and orientation programmes are used interchangeably by the Human Resource Department - hence, there was no formal induction process conducted. The induction and orientation process is not being evaluated to review the programme. The facility managers’ participation in the study assisted with their supportive roles in the career development of the health professionals. CONCLUSION It is hoped that the findings of this study will be of benefit to the Health Professionals in the Department of Health, Mpumalanga Province, South Africa. In addition, the study assessed the Management of Career Development programme which is used by the Department of Health in Mpumalanga Province to strengthen the induction and orientation programme of health professionals.
HIV and hepatitis B/C co-infection in KwaZulu-Natal from 2002 to 2010 : a retrospective database analysis.
(2015) Tathiah, Nerisha.; Bagwandeen, Chauntelle Ingrid.; Moodley, Prashini.
Introduction Sub-Saharan Africa has the highest Human Immunodeficiency Virus (HIV) prevalence and the second highest Hepatitis B virus (HBV) and Hepatitis C virus (HCV) prevalence in the world. Co-infection of HIV, HBV and HCV occurs due to shared transmission routes and common risk factors. Existing studies from sub-Saharan Africa show wide variations in the prevalence of co-infections, depending on age, gender, race and geographical area. Aim The aim of this study was to describe HIV and HBV/HCV co-infections in KwaZulu-Natal from 2002 to 2010 using a laboratory database. Methods An observational, analytical, retrospective study design was used. The study setting was the National Health Laboratory Service Department of Virology, in Durban. The study population consisted of 507 834 individuals (all those with HIV, HBV or HCV test results from 2002 to 2010 recorded in the database). Results The overall sero-prevalence of HIV was 47%, HBV:12.05% and HCV:4.13%. The highest sero-prevalence of HIV and HCV was in the 30-35 year age group; for HBV it was in the 20-25 year age group. HIV sero-prevalence was higher in females, while HBV and HCV sero-prevalence was higher in males. The uThukela, Amajuba and Zululand health districts had the highest HIV, HBV and HCV sero-prevalence respectively. The sero-prevalence of HIV and HBV has decreased significantly over time, while there was no significant change in the sero-prevalence of HCV. Compared to those without HIV, individuals with HIV had increased odds of being positive for hepatitis markers: 3.19 for Hepatitis B surface antigen, 2.06 for Hepatitis B e antigen and 2.91 for HCV. Those with HIV were less likely to be positive for Hepatitis B surface antibodies. Those with Hepatitis B had a 1.38 times the odds of being co-infected with HCV compared to those without HBV. Discussion This study documented the high sero-prevalence of HIV, HBV and HCV over 9 years for KwaZulu-Natal. A significant number of HIV positive individuals are co-infected with either HBV or HCV. Recommendations The results of this study may guide public health decisions on the approach to diagnosis, treatment and prevention of HBV and HCV among those with HIV.
“Sowing the seeds” the use of feedback in postgraduate medical education : a key factor in developing and enhancing clinical competence.
(2016) Bagwandeen, Chauntelle Ingrid.; Singaram, Veena S.
Background: The importance of feedback in enhancing clinical competency in the postgraduate medical education arena is well documented. Many definitions of, and models and frameworks for delivering feedback exist. Trainee specialists must learn how to use the feedback that they receive to hone their knowledge, skills and professional performance. Clinical supervisors must be equally effective in delivering the best feedback possible in all spheres of the training platform so as to impact positively on performance. However, while many studies have explored how feedback is given and received in postgraduate medical education, these studies have been conducted in homogenous settings. Aim: This study set out to examine how contextual and demographic factors affect the provision of feedback in a clinical training environment with heterogeneous demographics. This study aimed to investigate the perceptions of the registrars, consultants and Clinical Training Heads regarding the quality and factors that influence the process of giving and receiving feedback, so as to make recommendations for improvement and to develop policy guidelines for the enhancement of postgraduate clinical speciality training in diverse clinical training environments. Methods: A mixed methods approach was adopted for this study. Qualitative and quantitative analysis was done regarding the perceptions of the quality of the current delivery of feedback across six disciplines at a teaching hospital. Consultants and registrars consented to complete a questionnaire consisting of open- and close-ended questions to determine the quality, quantity, type and timing of feedback. Responses were coded on a five-point Likert Scale and combined to give an overall positive or negative response. The relationship between demographic factors such as age, race, gender, home language and discipline of study were also evaluated, with responses to open-ended questions used to extend and enrich the quantitative data. Descriptive statistics were used to analyse the data. Differences between groups were calculated using Pearson’s Chi Square test for independent variables, with a p–value of < 0.05 regarded as being statistically significant. Semi-structured interviews were conducted with the Clinical Training Heads to explore their feedback regarding the feedback received about feedback from the consultants and registrars. The Walt and Gilson (1994) triangular framework for policy analysis was used to explore the perceptions of current practice of the Clinical Training Heads of six major disciplines. A thematic analysis was conducted of their perceptions of how feedback was currently given and received by consultants and registers, with a view to developing policy guidelines to improve the practise of giving and receiving feedback. Results: The results revealed a disparity in the perceptions of consultants and registrars regarding current practise. Although consultants believed that they provided adequate feedback, registrars disagreed, citing an overall dissatisfaction with the process. Registrars believed that consultants lacked training in how to give feedback , and that important elements such as prior provision of the standards to be obtained, as well as feedback being based on directly observed performance were missing. Consultants concurred that they lacked capacity in how to give adequate feedback, but felt that heavy workloads, fear of negative reactions and the apathy of registrars as well as their failure to act on feedback when given, hampered the process. Male consultants and registrars both reported better experiences of giving and receiving feedback overall. Registrars who were English second language speakers had statistically significantly more favourable outcomes with feedback compared to English first language speakers. The Clinical Training Heads reported that lack of appropriate institutional support and an overall guiding framework, combined with multiple administrative bodies of registrars as well as language barriers, were challenges to be overcome. They identified areas for future improvement, including standardisation of the process, more effective use of logbooks and better monitoring and evaluation. Conclusion: Registrars and consultants agreed that feedback was essential to ensuring that clinical competencies were achieved. However, ongoing in-service education and training of consultants and registrars was necessary to ensure that consultants were fully capacitated to provide constant, high quality feedback and that registrars were able to recognise feedback when it was given. Feedback needs to be an integral part of the culture of the university teaching and learning ethos. To this end, policy guidelines incorporating elements of identified ‘Best Practices’ on how to give feedback were developed and recommended for implementation under the auspices of an overarching Postgraduate Committee for Teaching and Learning.