Browsing by Author "Niba, Mercy Bi."

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Communication between healthcare workers and Isizulu speaking female patients at the Scottsville clinic, Pietermaritzburg, South Africa.
(2000) Niba, Mercy Bi.; Leach, Athol Brian.
This study sought to establish some ofthe problems that occur during a consultation process between a healthcare worker and a patient, such as intangible and tangible verbal/nonverbal communication problems. Tangible nonverbal problems refer to eye contact, gestures, body posture and facial expression. Tangible verbal problems refer to voice tone/attitude and language and intangible to race, age, gender, education and culture. It was made clear that the problems involved in the consultation process were, in the main, common to other fonns of communication such as that between a reference librarian and a client, customer, visitor or user. The factors that hindered communication were investigated by means of semi-structured interviews and questionnaires. The sample population was made up of 100 black isiZulu speaking females and seven healthcare workers of a heterogeneous background. The perception ofthe respondents in relation to the above-named factors (language, age, gender, attitude, culture, education, gestures and postures) was sought. The analysis of the results obtained showed that some of the significant factors that are a problem in communication include voice tone/attitude, eye contact, sitting position, gestures, facial expression and language. Patients, for the sake ofeffective concentration and free flow ofinfonnation, preferred healthcare workers who were polite, had a cheerful demeanour and who sat still and straight up (not looking around or standing). This is noted because the majority of the patients acknowledged such healthcare workers and were not satisfied with those who behaved otherwise. For example, in relation to previous consultations (irrespective of the Clinics), out of the 70 respondents who encountered problems, 61 (87%) in despair cited cases of rudeness, of which the majority of such cases related to African healthcare workers. Culture also mattered, when seen in terms of people being able to speak the same language and understand one another, with respect to the contextual meaning of words. As far as eye contact was concerned, it was apparent that adjustments had been made. For example, it was discovered that although it is the Zulu culture to avoid eye contact, especially between the young and the old, Zulu people have come to accept eye contact in a crosscultural South Africa. Their acceptance was also seen as due to the advantages ofeye contact. This was made clear by the fact that ofthe 90 (91%) respondents who acknowledged the fact that the healthcare workers maintained eye contact during the consultation process, 87 (97%) said it was polite as it gave them the assurance that the healthcare workers were paying attention to what they were saying. Among the socio-demographic variables investigated, the gender of the healthcare worker emerged as one ofthe important predictors of effective communication. This is because the majority of the respondents indicated feeling freer with someone of the same gender groupmg. Certain recommendations were made which were considered vital in improving not only the consultation process but any other form of communication, including that between a reference librarian and a client. The main recommendations were that the healthcare workers be polite and endeavour to speak the main language as the patients. Due to the fact that some healthcare workers hurry during consultation, it was recommended that more staff be employed.
The value of participatory and non-participatory implementation and evaluation methodologies of HIV/AIDS communication-based interventions in southern Africa.
(2004) Niba, Mercy Bi.; Green, Jannette Maryann.; Dalrymple, Lynn I.
HIV/AIDS is an epidemic that is in one way or another affecting humankind and particularly the African continent. Due to its devastating nature, many strategies and interventions are being employed at different levels and by different groups of people to fight it. Evaluation has been a component of these projects, but few have been subjected to systematic monitoring and evaluation that provides a foundation for the development and implementation of further projects. This is partly due to the fact that project implementation and evaluation can be rendered complex by several factors, such as the choice of methodologies, donor satisfaction and the very nature of interventions and evaluations themselves. Taking a situation where the aim of a project and its evaluation is to bring about social change, as is the case with many HIV/AIDS interventions, this study sought to investigate approaches that could be considered meaningful, useful and valuable. In order to carry out the investigation of this study, the approach taken was an in-depth analysis of a few cases (in anticipation of greater achievement of insight), rather than broader survey types of perspectives. The study also concentrated on a review of the literature and on validation of documentary and interview evidence provided by beneficiaries, managerial staff and evaluators of communication-based HIV/AIDS. Results of the study highlighted the fact that community-based factors, such as education, poverty, culture, beliefs, gender, crime and age, influenced social change (with respect to HIV/AIDS) in varying ways and depending on the communities concerned. The different ways in which these factors influenced social change within specific communities were noted to have implications on interventions dealing with them. As such, an in-depth assessment of these different ways with respect to specific groups of people was encouraged in order to have a meaningful, useful and valuable HIV/AIDS intervention. The theory of active participation of targeted communities was also propagated in an HIV/AIDS intervention. It was noted that when active participation is encouraged in a project at both implementation and evaluation, taking the example of an HIV/AIDS project that intended achieving group knowledge acquisition, awareness, attitude change, skills acquisition, effective functioning and sustainability, such participation would contribute to: • Override to a great extent, limitations arising from socio-demographic differences (project locations and gender, language, age and race of implementers, evaluators and beneficiaries), in the attainment of project objectives. • Override to a great extent, limitations arising from differences in forms of evaluation (internal versus external evaluators), in the assessment of project objectives. • Create an enabling environment for higher attainment of project objectives in comparison to a situation where active participation is encouraged only at implementation (and not at evaluation). It was further discovered from this study that when beneficiaries are excluded from participating in the planning, action-planning and result-feedback stages of a project and its evaluation, dissatisfaction is experienced on the part of these beneficiaries as well as missed opportunities for useful contributions. The degree and quality of beneficiary involvement in project implementation and evaluation was seen to generate beneficiary excitement and a general sense of project acceptance: all of which was noted to create an enabling environment for the making of proper choices and decisions. Finally, difficulty in accessing traditional evaluations and people's feeling of shame and ineffectiveness was noted in the work (in the area of collecting data pertaining to traditional evaluation). This pointed to possible compromise of meaningfulness, usefulness and value of traditional evaluations.