Primary health care nurses' mental health knowledge and attitudes towards patients and mental health care in a South African metropolitan municipality.

Background: In South Africa, there are on-going calls to integrate mental health services into existing primary health care (PHC) programmes such as Tuberculosis (TB). Successful service integration and quality service delivery partially depend on healthcare providers' mental health-related knowledge and attitudes. The aim of this study was to assess PHC nurses' mental health knowledge and attitudes towards mental health patients and mental health care.

Construct validity and reliability of the perceived stress scale for nursing students in South Africa.

Background:  Increased levels of stress in nursing students are negatively related to caring behaviours and also result in poorer job proficiency and nurses who are more inclined to leave the profession. The Perceived Stress Scale (PSS), developed by Sheu and colleagues, is one of the most cited instruments for measuring stress and sources of stress amongst nursing students in international studies. However, it has not been widely validated for this purpose.

Factors Associated with Limited Vaccine Literacy: Lessons Learnt from COVID-19.

Compared to many other developed countries, South Africa has a lower uptake of COVID-19 vaccinations. Although not widely researched, there is evidence that vaccine literacy (VL) is positively associated with vaccination uptake. Therefore, this study aimed to assess levels of VL among the adult population in South Africa, as well as to identify factors associated with limited VL.

Post-Traumatic Stress and Coping Strategies of South African Nurses during the Second Wave of the COVID-19 Pandemic.

Prior to the 2019 novel coronavirus (COVID-19) outbreak, the South African healthcare system was already under severe strain due to amongst others, a lack of human resources, poor governance and management, and an unequal distribution of resources among provinces and between the public and private healthcare sectors. At the center of these challenges are nurses, the backbone of the healthcare system, and the first point of call for most patients in the country. This research investigated post-traumatic stress and coping strategies of nurses during the second wave of COVID-19 in the country.

Yield of systematic household contact investigation for tuberculosis in a high-burden metropolitan district of South Africa.

Background: Systematic household contact investigation (SHCI) is recommended as an active-case-finding (ACF) strategy to identify individuals at high risk of tuberculosis (TB) infection, in order to enable early detection and treatment. Reluctance to implement SHCI in sub-Saharan African and South African high-burden contexts may stem from uncertainty about the potential yield of this strategy when targeting specific categories of TB index cases. In order to inform and motivate scale-up, this pilot study investigated the effectiveness of SHCI when targeting the World Health Organization's (WHO) recommended categories of infectious index cases.

Tuberculosis infection control practices in a high-burden metro in South Africa: A perpetual bane for efficient primary health care service delivery.

Background: Tuberculosis (TB) prevention, including infection control, is a key element in the strategy to end the global TB epidemic. While effective infection control requires all health system components to function well, this is an area that has not received sufficient attention inSouth Africa despite the availability of policy and guidelines.

Aim: To describe the state of implementation of TB infection control measures in a high-burden metro in South Africa.

Strengthening Human Immunodeficiency Virus and Tuberculosis Prevention Capacity among South African Healthcare Workers: A Mixed Methods Study of a Collaborative Occupational Health Program.

Background: Insufficient training in infection control and occupational health among healthcare workers (HCWs) in countries with high human immunodeficiency virus (HIV) and tuberculosis (TB) burdens requires attention. We examined the effectiveness of a 1-year Certificate Program in Occupational Health and Infection Control conducted in Free State Province, South Africa in an international partnership to empower HCWs to become change agents to promote workplace-based HIV and TB prevention.

Methods: Questionnaires assessing reactions to the program and Knowledge, Attitudes, Skills, and Practices were collected pre-, mid-, and postprogram.

Tuberculosis knowledge, attitudes and practices of patients at primary health care facilities in a South African metropolitan: research towards improved health education.

Background: Health education is important to empower patients and encourage their contribution towards tuberculosis (TB) control. In South Africa, health education activities are integrated into services provided at the primary health care (PHC) level. This study was conducted in a high TB burden metropolitan area in South Africa.

Workplace interventions to reduce HIV and TB stigma among health care workers - Where do we go from here?

Fear of stigma and discrimination among health care workers (HCWs) in South African hospitals is thought to be a major factor in the high rates of HIV and tuberculosis infection experienced in the health care workforce. The aim of the current study is to inform the development of a stigma reduction intervention in the context of a large multicomponent trial. We analysed relevant results of four feasibility studies conducted in the lead up to the trial.

Barriers to HIV counseling and testing uptake by health workers in three public hospitals in Free State Province, South Africa.

Recent WHO/ILO/UNAIDS guidelines recommend priority access to HIV services for health care workers (HCWs), in order to retain and support HCWs, especially those at risk of occupationally acquired tuberculosis (TB). The purpose of this study was to identify barriers to uptake of HIV counselling and testing (HCT) services for HCWs receiving HCT within occupational health units (OHUs). Questions were included within a larger occupational health survey of a 20% quota sample of HCWs from three public hospitals in Free State Province, South Africa.

Considerations for preparing a randomized population health intervention trial: lessons from a South African-Canadian partnership to improve the health of health workers.

Background: Community-based cluster-randomized controlled trials (RCTs) are increasingly being conducted to address pressing global health concerns. Preparations for clinical trials are well-described, as are the steps for multi-component health service trials. However, guidance is lacking for addressing the ethical and logistic challenges in (cluster) RCTs of population health interventions in low- and middle-income countries.

Patient- and delivery-level factors related to acceptance of HIV counseling and testing services among tuberculosis patients in South Africa: a qualitative study with community health workers and program managers.

Background: South Africa has a high tuberculosis (TB)-human immunodeficiency virus (HIV) coinfection rate of 73%, yet only 46% of TB patients are tested for HIV. To date, relatively little work has focused on understanding why TB patients may not accept effective services or participate in programs that are readily available in healthcare delivery systems. The objective of the study was to explore barriers to and facilitators of participation in HIV counseling and testing (HCT) among TB patients in the Free State Province, from the perspective of community health workers and program managers who offer services to patients on a daily basis.

Scaling up access to antiretroviral drugs in a middle-income country: public sector drug delivery in the Free State, South Africa.

This article describes the distribution and management of drugs and supplies in scaling up access to public sector antiretroviral treatment (ART) in a middle-income country. More specifically, a case study of the Free State Province of South Africa is presented focusing on: the mobilisation and training of pharmaceutical staff for ART, processes related to the ordering, distribution and storage of medicines, continuity of ART supplies and the impact of ART delivery on other drugs and supplies. Data were obtained from longitudinal research conducted between April 2004 and July 2006 comprising three surveys of the first 20 health facilities providing ART in the province, key informant interviews and observations made of provincial ART Task Team meetings.